Left Ventricle Geometry Remolding after Heart Transplantation： A Two-dimensional Ultrasound Study

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 33; no. 6; pp. 892 - 896
• Main Author: 覃小娟 李贺 尤君 吕清 张菁 高菡静 谢明星
• Format: Journal Article
• Language: English
• Published: Heidelberg Huazhong University of Science and Technology 01.12.2013; Department of Medical Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China%Department of Cardiosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China%Department of Medical Ultrasound, People's Liberation Army 161st Central Hospital, Wuhan 430012, China
• Subjects: Adult; Cardiomegaly - diagnostic imaging; Cardiomegaly - etiology; Case-Control Studies; Echocardiography; Female; Heart Transplantation - adverse effects; Heart Ventricles - diagnostic imaging; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Postoperative Period; Ventricular Remodeling; 二维; 几何图案; 左心室; 心室重构; 心脏移植; 排斥反应; 质量指数; 超声心动图; left ventricular remodeling; left ventricular hypertrophy; heart transplantation; two-dimensional echocardiography
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-013-1217-5

The function of the transplanted heart will be affected by acute allograft rejection, chronic rejection, high blood pressure and so on, which may induce the reconstruction of the left ventricle and the increase of left ventricular mass （LVM）, and eventually lead to left ventricular hypertrophy that will significantly affect the prognosis of heart transplantation （HT）. The purpose of this study was to dy- namically monitor the changes of left ventricular geometric patterns after HT using two-dimensional echocardiography and to understand the remodeling process and its possible influencing factors. The left ventricular internal diameter, interventricular septal wall thickness, posterior wall thickness at end dias- tole were measured and the relative wall thickness （RWT）, left ventricular mass, left ventricular mass index were calculated respectively in 34 HT patients and 34 healthy volunteers by two-dimensional echocardiography. The type of left ventricular geometry was identified based on the echocardiographic determination of LVM index （LVMI） and RWT. The HT patients were divided into three groups ac- cording to the time length after surgery： A （3 months postoperatively）, B （6 months postoperatively） and C （12 months postoperatively）. We compared the parameters of left ventricle between HT group and normal control group, and explored the risk factors causing the increase of LVM. The results showed that 4 patients （16%） in group A had concentric remodeling. Nine patients （34.62%） in group B had re- construction, including 5 cases of concentric remodeling, 2 cases of concentric hypertrophy and 2 cases of eccentric hypertrophy. The hypertrophy incidence rate was 15.4% in group B. 15 patients （62.5%） had reconstruction in group C, including 9 cases of concentric remodeling, 5 cases of concentric hyper- trophy, and 1 case of eccentric hypertrophy. The prevalence of hypertrophy was 25%. Multivariate analysis showed that hypertension and acute rejection history were the risk factors that resulted in left ventricular hypertrophy. It is concluded that the left ventricular remodeling occurs following cardiac transplantation at an early stage and the incidence of left ventricular hypertrophy increases with survival time. In this study, the one-year prevalence of left ventricular hypertrophy was 25% after surgery. Hy- pertension and acute rejection history are risk factors that can predict the left ventricular hypertrophy.