Echocardiographic assessment of chamber size and ventricular function during the first year after heart transplantation

Annika Ingvarsson, Anna Werther Evaldsson, Johan Waktare, Oscar Braun, Gustav Jan Smith, Anders Roijer, Göran Rådegran, Carl Meurling

Research output: Contribution to journalArticlepeer-review


AIMS: Detecting changes in ventricular function after orthotopic heart transplantation (OHT) using transthoracic echocardiography (TTE) is important but interpretation of findings is complicated by lack of data on early graft adaptation. We sought to evaluate echocardiographic measures of ventricular size and function the first year following OHT including speckle tracking derived strain. We also aimed to compare echocardiographic findings to hemodynamic parameters obtained by right heart catheterization (RHC).

METHODS AND RESULTS: Fifty OHT patients were examined prospectively with TTE and RHC at 1, 6, and 12 months after OHT. Left ventricle (LV) was assessed with fractional shortening, ejection fraction, and systolic tissue velocities. Right ventricular (RV) evaluation included tricuspid annular plane systolic excursion (TAPSE), systolic tissue velocity (S´) and fractional area change (FAC). LV global longitudinal and circumferential strain and RV global longitudinal strain (GLS) and RV lateral wall strain (RVfree) were analysed. No relevant changes occurred in LV echocardiographic parameters, whereas all measures of RV function improved significantly during follow up. There was an increase in TAPSE (12.4±3.3 mm to 14.4±4.3 mm, p<0.01), FAC (36±8% to 41±8%, p<0.01), RV GLS (-15.8±3.4% to -17.8±3.6%, p<0.01) and RVfree (-15.5±3.7% to -18.6±3.6%, p<0.001). Between one and twelve months pulmonary pressures decreased, whereas pulmonary vascular resistance did not.

CONCLUSION: Stable OHT recipients reached steady state regarding LV function one month after transplantation. In contrast, RV function displayed gradual improvement the first year following OHT, indicating delayed RV-adaptation as compared to the LV. Improved RV function-parameters were independent of invasively measured pulmonary pressures.

Original languageEnglish
Pages (from-to)355-365
Number of pages11
JournalClinical Physiology and Functional Imaging
Issue number4
Early online date2021 Apr 8
Publication statusPublished - 2021 Jul 1

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems


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