The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients

Abstract

Background: Transplanted patients are frail individuals who may be affected by diastolic dysfunction, leading to a decrease in exercise tolerance. Previous studies have reported that certain ECG and echocardiographic parameters (such as the P-wave interval, PQ interval, P-wave dispersion, Tend-P interval, QTc interval, and strain) can support the diagnosis of diastolic dysfunction when the ejection fraction is preserved. This study aimed to examine the potential diagnostic contribution of specific ECG and deformation parameters in transplanted recipients, who are at a high risk of heart failure. Materials and Methods: A group of 33 transplanted subjects (17 renal and 16 liver) were categorized using two scores for heart failure with preserved ejection fraction (HFpEF). Additionally, they underwent evaluation based on ECG parameters (P-wave interval, PQ interval, Pwave dispersion, and Tend-P QTc) and echocardiographic deformation parameters (strain and twist). The Student’s t-test was used for statistical analysis. Results: The two scores identified different numbers of excludable and not excludable subjects potentially affected by HFpEF. The not excludable group presented ECG parameters with significantly higher values (P-wave, PQ interval, posterior wall diastole, and Tend-P, all with p ≤ 0.05) and significantly lower 4D strain and twist values (p < 0.05) Conclusions: There is evidence for a significant diagnostic contribution of additional ECG and echo strain parameters in an early phase of diastolic dysfunction in subjects potentially affected by HFpEF.

Keywords

• HFpEF
• organ transplantation
• H2FPEF
• HFA-PEF
• exercise prescription