E897 JACC March 12, 2013 Volume 61, Issue 10
Imaging Improvements in Right Ventricular Performance in Patients with Pulmonary Hypertension after Lung Transplantation by Speckle-Tracking Strain Echocardiography Poster Contributions Poster Sessions, Expo North Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Echo: RV Imaging Abstract Category: 18. Imaging: Echo Presentation Number: 1179-328 Authors: Tetsuari Onishi, Toshinari Onishi, Akiko Mano, Hunter Champion, Norihisa Shigemura, John Gorcsan, University of Pittsburgh Medical Center, Pittsburgh, PA, USA Backgroud: Right ventricular (RV) function is an important determinant of clinical outcomes in patients with pulmonary hypertension (PH) before and after lung transplantation. Objective: To assess RV performance by speckle-tracking strain before and after lung transplantation in patients with chronic PH. Methods: We studied 28 patients aged 60±11 years with chronic PH before and after lung transplantation. Speckle tracking strain was used to assess global longitudinal strain (GLS) and standard deviation of the time to peak strain in RV wall (T-SD). Routine parameters were RV end-diastolic and end-systolic area (RVEDA and RVESA) and fractional area change (FAC). Pulmonary artery pressure and vascular resistance were estimated by Doppler (eSPAP and ePVR). Results: From before to after lung transplantation, RV speckle tracking strain demonstrated significant increases in GLS from -11±4 to -16±4%, p<0.0001, and T-SD improved from 100±67 to 71±27ms, p<0.05. in addition, improvements occurred in RVEDA (28±10 to 20±4cm2, p=0.0003), RVESA (21±9 to 13±2cm2, p=0.0001), RVFAC (26±8 to 35±7%, p<0.0001), eSPAP (72±24 to 45±16mmHg, p=0.002), and ePVR (3.8±1.4 to 2.2±0.9 Wood Units, p=0.003). Conclusions: RV performance by global longitudinal strain significantly increased after lung transplantation along with improvements in pulmonary artery pressures and RV size. Speckle tracking strain has clincial utility to assess changes in RV performance in patients with PH.