Ability of Tissue Doppler and Strain/Strain Rate Imaging to Identify Patients who have Acute Rejection after Cardiac Transplantation

  • Xiaoyan Gu, Beijing Anzhen Hospital, Capital University of Medical Sciences, China
  • Yihua He, Beijing Anzhen Hospital, Capital University of Medical Sciences, China
  • Zhian Li, Beijing Anzhen Hospital, China
  • Michael Kontos, Virginia Commonwealth University, Richmond, United States
  • J V Nixon, Virginia Commonwealth University, Richmond, United States

    • Objective: To determine the ability of Tissue Doppler imaging (TDI) and two-dimensional strain and strain rate imaging (2D S/SR) to identify patients with acute rejection (AR) after cardiac transplantation as, compared with pathological examination.
    Methods: Thirty endomyocardial biopsies (EMBs) were taken from 25 cardiac transplantation patients and graded according to International Society Heart Lung Transplantation criteria. A group of 30 age-matched patients comprised the control group. TDI and 2D S/SR studies were performed in each patient and were compared between groups.
    Results: Of the 30 EMBs, 12 showed AR grade 0, 10 showed AR grade Ιa-Ιb, and 8 showed AR grade ≥IIa. Peak early diastolic wall motion velocity, peak systolic wall motion velocity, early systolic time, peak of systolic longitudinal stain of basal-septum, circumferential strain rate of ant-septum, and radial strain of all segments at the level of mitral valve were significantly reduced in patients with AR ≥IIa than those with rejection Conclusions: TDI and 2D S/SR imaging are effective and sensitive techniques for the early detection of sub-clinical tissue rejection after CT. More severe rejection is associated with further significant changes in TDI and 2D S/SR imaging.