Non-invasive detection of acute allograft rejection in children by tissue Doppler imaging: Myocardial velocities and myocardial acceleration during isovolumic contraction

Linda B. Pauliks, Biagio A. Pietra, Curt G. DeGroff, Kenneth Scott Kirby, Ole A. Knudson, Loralee Logan, Mark M. Boucek, Lilliam M. Valdes-Cruz

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: In adults, an acute decrease of regional myocardial velocities is a sensitive marker of rejection. In children, velocities are more variable. A new marker, myocardial acceleration during isovolumic contraction (IVA), appears to be less age-dependent than myocardial velocities. This study therefore compared tissue Doppler (TDI)-derived velocities and IVA as potential rejection markers for children. Methods: TDI was performed in 15 pediatric heart transplant recipients (age 8.0 ± 3.6 years) during acute rejection and at baseline without rejection, 50 additional transplant children without rejection (7.8 ± 5.9 years) and 30 age-matched healthy children (7.5 ± 5.2 years). Color Doppler cine-loops of 3 cardiac cycles were stored as echocardiographic raw data. Using off-line post-processing, systolic (S) and diastolic (E) myocardial velocities and IVA were measured in 5 basal left ventricular segments. IVA is the peak isovolumic contraction wave velocity divided by acceleration time. Results: Without rejection, transplant children had significantly lower diastolic velocities (basal lateral E 10.4 ± 2.9 vs 11.9 ± 2.6 cm/s; p < 0.001) and systolic velocities (S 5.6 ± 1.4 vs 7.1 ± 2.0 cm/s; p < 0.001) than normal age-matched controls, but IVA was similar (1.2 ± 1.4 vs 1.3 ± 0.5 m/s2). During rejection, all markers decreased significantly compared with age-matched normal control, the non-rejecting transplant group and individual baseline values. Conclusions: Regional myocardial velocities change significantly during acute allograft rejection in children. However, many children already have wall motion abnormalities at baseline, so results are often difficult to interpret. In contrast, isovolumic acceleration was normal without rejection and selectively decreased during the event. IVA is a promising non-invasive rejection marker for pediatric patients.

Original languageEnglish (US)
Pages (from-to)S239-S248
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number7 SUPPL.
DOIs
StatePublished - Jul 1 2005

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Allografts
Pediatrics
Transplants
Graft Rejection
Color

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Pauliks, Linda B. ; Pietra, Biagio A. ; DeGroff, Curt G. ; Kirby, Kenneth Scott ; Knudson, Ole A. ; Logan, Loralee ; Boucek, Mark M. ; Valdes-Cruz, Lilliam M. / Non-invasive detection of acute allograft rejection in children by tissue Doppler imaging : Myocardial velocities and myocardial acceleration during isovolumic contraction. In: Journal of Heart and Lung Transplantation. 2005 ; Vol. 24, No. 7 SUPPL. pp. S239-S248.
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title = "Non-invasive detection of acute allograft rejection in children by tissue Doppler imaging: Myocardial velocities and myocardial acceleration during isovolumic contraction",
abstract = "Background: In adults, an acute decrease of regional myocardial velocities is a sensitive marker of rejection. In children, velocities are more variable. A new marker, myocardial acceleration during isovolumic contraction (IVA), appears to be less age-dependent than myocardial velocities. This study therefore compared tissue Doppler (TDI)-derived velocities and IVA as potential rejection markers for children. Methods: TDI was performed in 15 pediatric heart transplant recipients (age 8.0 ± 3.6 years) during acute rejection and at baseline without rejection, 50 additional transplant children without rejection (7.8 ± 5.9 years) and 30 age-matched healthy children (7.5 ± 5.2 years). Color Doppler cine-loops of 3 cardiac cycles were stored as echocardiographic raw data. Using off-line post-processing, systolic (S) and diastolic (E) myocardial velocities and IVA were measured in 5 basal left ventricular segments. IVA is the peak isovolumic contraction wave velocity divided by acceleration time. Results: Without rejection, transplant children had significantly lower diastolic velocities (basal lateral E 10.4 ± 2.9 vs 11.9 ± 2.6 cm/s; p < 0.001) and systolic velocities (S 5.6 ± 1.4 vs 7.1 ± 2.0 cm/s; p < 0.001) than normal age-matched controls, but IVA was similar (1.2 ± 1.4 vs 1.3 ± 0.5 m/s2). During rejection, all markers decreased significantly compared with age-matched normal control, the non-rejecting transplant group and individual baseline values. Conclusions: Regional myocardial velocities change significantly during acute allograft rejection in children. However, many children already have wall motion abnormalities at baseline, so results are often difficult to interpret. In contrast, isovolumic acceleration was normal without rejection and selectively decreased during the event. IVA is a promising non-invasive rejection marker for pediatric patients.",
author = "Pauliks, {Linda B.} and Pietra, {Biagio A.} and DeGroff, {Curt G.} and Kirby, {Kenneth Scott} and Knudson, {Ole A.} and Loralee Logan and Boucek, {Mark M.} and Valdes-Cruz, {Lilliam M.}",
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Non-invasive detection of acute allograft rejection in children by tissue Doppler imaging : Myocardial velocities and myocardial acceleration during isovolumic contraction. / Pauliks, Linda B.; Pietra, Biagio A.; DeGroff, Curt G.; Kirby, Kenneth Scott; Knudson, Ole A.; Logan, Loralee; Boucek, Mark M.; Valdes-Cruz, Lilliam M.

In: Journal of Heart and Lung Transplantation, Vol. 24, No. 7 SUPPL., 01.07.2005, p. S239-S248.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Non-invasive detection of acute allograft rejection in children by tissue Doppler imaging

T2 - Myocardial velocities and myocardial acceleration during isovolumic contraction

AU - Pauliks, Linda B.

AU - Pietra, Biagio A.

AU - DeGroff, Curt G.

AU - Kirby, Kenneth Scott

AU - Knudson, Ole A.

AU - Logan, Loralee

AU - Boucek, Mark M.

AU - Valdes-Cruz, Lilliam M.

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Background: In adults, an acute decrease of regional myocardial velocities is a sensitive marker of rejection. In children, velocities are more variable. A new marker, myocardial acceleration during isovolumic contraction (IVA), appears to be less age-dependent than myocardial velocities. This study therefore compared tissue Doppler (TDI)-derived velocities and IVA as potential rejection markers for children. Methods: TDI was performed in 15 pediatric heart transplant recipients (age 8.0 ± 3.6 years) during acute rejection and at baseline without rejection, 50 additional transplant children without rejection (7.8 ± 5.9 years) and 30 age-matched healthy children (7.5 ± 5.2 years). Color Doppler cine-loops of 3 cardiac cycles were stored as echocardiographic raw data. Using off-line post-processing, systolic (S) and diastolic (E) myocardial velocities and IVA were measured in 5 basal left ventricular segments. IVA is the peak isovolumic contraction wave velocity divided by acceleration time. Results: Without rejection, transplant children had significantly lower diastolic velocities (basal lateral E 10.4 ± 2.9 vs 11.9 ± 2.6 cm/s; p < 0.001) and systolic velocities (S 5.6 ± 1.4 vs 7.1 ± 2.0 cm/s; p < 0.001) than normal age-matched controls, but IVA was similar (1.2 ± 1.4 vs 1.3 ± 0.5 m/s2). During rejection, all markers decreased significantly compared with age-matched normal control, the non-rejecting transplant group and individual baseline values. Conclusions: Regional myocardial velocities change significantly during acute allograft rejection in children. However, many children already have wall motion abnormalities at baseline, so results are often difficult to interpret. In contrast, isovolumic acceleration was normal without rejection and selectively decreased during the event. IVA is a promising non-invasive rejection marker for pediatric patients.

AB - Background: In adults, an acute decrease of regional myocardial velocities is a sensitive marker of rejection. In children, velocities are more variable. A new marker, myocardial acceleration during isovolumic contraction (IVA), appears to be less age-dependent than myocardial velocities. This study therefore compared tissue Doppler (TDI)-derived velocities and IVA as potential rejection markers for children. Methods: TDI was performed in 15 pediatric heart transplant recipients (age 8.0 ± 3.6 years) during acute rejection and at baseline without rejection, 50 additional transplant children without rejection (7.8 ± 5.9 years) and 30 age-matched healthy children (7.5 ± 5.2 years). Color Doppler cine-loops of 3 cardiac cycles were stored as echocardiographic raw data. Using off-line post-processing, systolic (S) and diastolic (E) myocardial velocities and IVA were measured in 5 basal left ventricular segments. IVA is the peak isovolumic contraction wave velocity divided by acceleration time. Results: Without rejection, transplant children had significantly lower diastolic velocities (basal lateral E 10.4 ± 2.9 vs 11.9 ± 2.6 cm/s; p < 0.001) and systolic velocities (S 5.6 ± 1.4 vs 7.1 ± 2.0 cm/s; p < 0.001) than normal age-matched controls, but IVA was similar (1.2 ± 1.4 vs 1.3 ± 0.5 m/s2). During rejection, all markers decreased significantly compared with age-matched normal control, the non-rejecting transplant group and individual baseline values. Conclusions: Regional myocardial velocities change significantly during acute allograft rejection in children. However, many children already have wall motion abnormalities at baseline, so results are often difficult to interpret. In contrast, isovolumic acceleration was normal without rejection and selectively decreased during the event. IVA is a promising non-invasive rejection marker for pediatric patients.

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