American Heart Journal Plus (Sep 2024)

Natural recovery of cardiac allograft diastolic function, a retrospective longitudinal report

  • Shengyi Fu,
  • Aditi G.M. Patel,
  • Mohammed Ruzieh,
  • Seri Hanayneh,
  • Juan Vilaro,
  • Mustafa M. Ahmed,
  • Juan M. Aranda, Jr,
  • Alex M. Parker,
  • Mark S. Bleiweis,
  • Jeffrey P. Jacobs,
  • Mohammad A. Al-Ani

Journal volume & issue
Vol. 45
p. 100428

Abstract

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Cardiac allografts suffer diastolic dysfunction early post-heart transplantation (HTx) due to ischemic injury, however the natural course of diastology recovery post HTx remains unknown (Tallaj et al., 2007 [1]). We retrospectively reviewed 60 adult HTx patients between 2015 and 2021 at a single site. Invasive hemodynamics and echocardiograms were obtained at 2 weeks and 1, 3, 6, and 12 months post-HTx. RA strain by 2D feature tracking was compared to intracardiac pressure measurements. In all patients, we observed normalization of RV and RA filling pressures by post-operative week 12 and recovery of diastolic dysfunction by month 6. There was an inverse correlation between RV end-diastolic pressure and RA contractile (r = −0.192, p < 0.05) and reservoir (r = −0.128, p < 0.05) functions in the allograft. As the post-transplant care paradigm shifts away from invasive procedures, right atrial indices should be included in imaging-based allograft surveillance studies.

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