Echocardiographic estimation of left ventricular filling pressures in heart transplant recipients

• Published in: The Egyptian heart journal Vol. 76; no. 1; pp. 12 - 8
• Main Authors: Rahbar, Zohreh, Tavoosi, Anahita, Bakhshandeh, Alireza, Mehrpooya, Maryam, Sardari, Akram, Larti, Farnoosh, Sattarzadeh Badkoubeh, Roya
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 30.01.2024; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Biopsy; Cardiac catheterization; Cardiology; Catheterization; Diastolic dysfunction; Doppler effect; E/e; Echocardiography; GLS; Heart; Heart transplantation; Heart transplants; Intubation; LVEDP; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Organ transplant recipients; Patients; Software; Statistical analysis; Transplantation; Ultrasonic imaging; Veins & arteries; Velocity; LVEDP; ′; Echocardiography; Heart transplantation; Diastolic dysfunction; /; GLS; E/e
• ISSN: 2090-911X; 1110-2608; 2090-911X
• DOI: 10.1186/s43044-024-00443-z

Background Echocardiographic estimation of left ventricular filling pressure in heart transplant (HTx) recipients is challenging. The ability of echocardiography to detect elevated left ventricular end-diastolic pressure (LVEDP) in HTx patients was assessed in this study. Results This descriptive cross-sectional study included 39 HTx recipients who were candidates for endomyocardial biopsy as a part of their routine post-transplantation surveillance. Doppler transthoracic echocardiography was done before the procedure, and left heart catheterization was done during the endomyocardial biopsy. Thirty-nine patients (15 female, 24 male), with a mean age of 39.6 years (range 13–70), were enrolled. A strong relation was observed between lateral E / e ′ and LVEDP ( R  = 0.64, P value < 0.001) and average E / e ′ and LVEDP ( R  = 0.6, P value < 0.001). The best cutoff value for LVEDP prediction was the average E / e ′ ≥ 6.8 with a sensitivity of 96.15% and specificity of 68.5% for the prediction of LVEDP more than or equal to 20 mmHg. Two predictive models comprising age, gender, and lateral E / e ′ or average E / e ′ were also proposed. A significant relationship was also found between LVEDP and left ventricular global longitudinal strain ( R  = − 0.31, P value < 0.01). Conclusions Lateral E / e ′ was the best predictor of LVEDP. The cutoff of average E / e ′ had the best validity for the estimation of LVEDP. Despite the strong observed association, echocardiographic parameters cannot be considered a surrogate for invasive LVEDP measurements when seeking information about left ventricle filling pressure on heart transplant recipients.