Echocardiographic evaluation of orthotopic heart transplantation: Single-Center experience

Background: In patients with advanced heart failure, significant improvement in pharmacological and non-pharmacological treatment strategies has conferred better survival rates and quality of life. Objectives: This is a report on echocardiographic findings in heart transplantation (HTx) patients in their first 5 postoperative months. Patients and Methods: Twenty patients undergoing HTx between September 2009 and July 2010 whose clinical and echocardiographic findings had been registered monthly for 5 months after HTx were enrolled. Results: Eleven males and five females at a mean age of 33 years [range = 17-58 years] were enrolled in the study. The mean of the left ventricular ejection fraction (LVEF) was 52 ± 8.2 % and 58 ± 2.5 % on the first day and at 5 months after HTx, respectively. There was no LV enlargement at 5 months' follow-up. The right ventricle (RV) was mildly enlarged, but the reduced baseline RV function showed improvement at the 5th postoperative month (mean TAPSE was 11.7 ± 3.3 mm on the first post-HTx day versus 17.2 ± 6.3 mm after 5 months; P < 0.005). The pulmonary arterial pressure was slightly elevated at baseline, and it showed no significant decrease 5 months after HTx. More than 90% of the cases showed only mild tricuspid regurgitation at 5 months' follow-up. The tissue Doppler imaging-derived velocities of the medial and lateral mitral annuli and the tricuspid annulus demonstrated a gradual increment during the follow-up and reached their highest value at 5 months' follow-up. Conclusions: The cardiac grafts at 5 months' post-HTx follow-up were characterized by normal LV dimensions and EF. Also, RV dysfunction and tricuspid regurgitation were frequent findings, but they were not associated with the clinical signs of congestive heart failure, morbidity, and mortality in the majority of our patients.