Impact of right ventricular systolic function after heart transplantation on exercise capacity
- 4 May 2020
- journal article
- research article
- Published by Wiley in Echocardiography
- Vol. 37 (5), 706-714
- https://doi.org/10.1111/echo.14650
Abstract
Background Right ventricular (RV) systolic parameters are difficult to assess in heart transplant recipients (HTRs) compared to healthy people because of discordant data, and their impact on exercise capacity remains undefined. We sought to retrospectively assess the impact of RV systolic function on exercise capacity after heart transplantation. Methods We analyzed data from 61 HTRs who underwent transthoracic echocardiography (TTE), cardiac magnetic resonance imaging (CMR), and exercise capacity assessment by 6‐minute walking test (6MWT) and cardiopulmonary exercise testing (CPET) at 1‐ and 2‐year follow‐ups. Results Transthoracic echocardiography RV longitudinal systolic function including tricuspid annular plan systolic excursion (TAPSE), peak systolic S′ wave tricuspid annular velocity (PSVtdi) and RV free wall longitudinal strain was decreased at 1 year (respectively, 15 ± 3 mm, 10 ± 3 cm/s, and −19 ± 5%) and at 2 years (respectively, 15 ± 3 mm, 10 ± 2 cm/s, and −20 ± 5%) with no significant difference between both evaluations; meanwhile, RV ejection fraction (RVEF) measured by CMR was preserved. Mean percentage of predicted peak oxygen consumption was altered, but improved between the first and second year (55 ± 18 vs 60 ± 18%, P = .038). PSVtdi was weakly correlated with 6MWT distance (r = .426, P = .017) and RVEF with the predicted distance at 6MWT (r = .410, P = .027) at the 1‐year follow‐up. Conclusions Despite decreasing values, RV longitudinal systolic function has a weak impact on exercise capacity of HTRs. PSVtdi and RVEF are the most pertinent parameters to assess the impact of RV systolic function on exercise capacity after heart transplantation. These results should lead to redefine normal RV systolic function thresholds for HTRs.Keywords
This publication has 20 references indexed in Scilit:
- Right heart morphology and function in heart transplantation recipientsJournal of Cardiovascular Medicine, 2013
- Marked changes in right ventricular contractile pattern after cardiothoracic surgery: Implications for post-surgical assessment of right ventricular functionThe Journal of Heart and Lung Transplantation, 2013
- Total Ischemia Time Alters the Longitudinal and Circumferential Shortening of the Right Ventricle in Transplanted HeartsSeminars in Cardiothoracic and Vascular Anesthesia, 2011
- Relationship Between Functional Capacity and Quality of Life in Heart Transplant PatientsTransplantation Proceedings, 2011
- Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography: Endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of EchocardiographyJournal of the American Society of Echocardiography, 2010
- The right ventricular annular velocity reduction caused by coronary artery bypass graft surgery occurs at the moment of pericardial incisionAmerican Heart Journal, 2010
- Right Ventricular Function in Cardiovascular Disease, Part ICirculation, 2008
- Normal Reference Values for the Adult Right Ventricle by Magnetic Resonance ImagingThe American Journal of Cardiology, 2006
- Exercise after heart transplantationEuropean Journal of Applied Physiology, 2003
- ATS StatementAmerican Journal of Respiratory and Critical Care Medicine, 2002