Left and Right Ventricular Function Detection and Myocardial Deformation Analysis in Heart Transplant Patients with Long-time Follow-ups

Objective: We try to investigate whether the values of longitudinal strain present differences between the left and right ventricles in long-time follow-ups after heart transplantation (HTx) with dynamic changes in function.

Methods And Results: Follow-up transthoracic echocardiography was performed in 1- and 3-month and 1- and 5-year follow-ups in 50 "healthy" HTx patients and compared with 26 control subjects. The left ventricle with preserved ejection fraction evaluated by biplane Simpson (control group [CG] vs HT; P > .05) had an obvious reduction in global (CG: -20.49 ± 2.38 vs heart transplant 1 month [HT1m]: -13.06 ± 2.86, heart transplant 3 month [HT3m]: -13.61 ± 2.61, heart transplant 1 year [HT1y]: -13.69 ± 4.56, heart transplant 5 year [HT5y]: -14.41 ± 4.54; P < .001) and horizontal segmental (basal, mid, apical) (P < .001) together with chamber segmental (apical 4-chamber, apical 3-chamber, apical 2-chamber) (P < .001) average strain values. The right ventricle with reduced ventricular function measured by tissue Doppler imaging S' and tricuspid annular plane systolic excursion had a more distinctive reduction in global (CG: -24.53 ± 4.20 vs HT1m: -12.94 ± 5.03, HT3m: -13.68 ± 4.35, HT1y: -14.95 ± 7.50, HT5y: -15.20 ± 6.15; P < .001) with segmental lateral (P < .001) strain values. There were not any significant changes between 1- and 3-month follow-ups of all the values (P > .05). But it could be seen that values increased in 1- and 5-year follow-ups compared with the baseline of 1- and 3-month follow-ups (P < .05). The global and segmental strain of the right ventricle decreased more than that of the left ventricle in all HTx groups, and the strain values were decreased in the HTx groups compared with the CG, with the global decreased change rates being 11%, 10%, 6%, and 8%, respectively.

Conclusions: The strain values decreased after HTx and almost remained stable in the long-time follow-ups. Compared with the CG in both ventricles, they were with preserved or reduced functions. In addition, the deformation values of the right ventricle decreased more than those of the left.