ABC | Volume 114, Nº4, April 2020

Original Article Carrion et al. Right ventricular dysfunction and heart transplant Arq Bras Cardiol. 2020; 114(4):638-644 Table 1 – Baseline characteristics of the study population Variable Value HTx recipientes (n = 19) Male sex, n (%) 8 (42%) Age at transplantation (years) 47.7 ± 12.4 Comorbidities Diabetes, n (%) 5 (25%) Hypertension, n (%) 4 (20%) Obesity, n (%) 4 (20%) Stroke, n (%) 5 (25%) Dyslipidemia, n (%) 1 (5%) Peripheral vascular disease, n (%) 3 (15%) Current smoker, n (%) 7 (35%) Time to HTx (days) 80 ± 105 Ischemic time before HTx (min) 225 ± 57 Heart failure etiology Ischemic heart disease, n (%) 2 (10%) Non-ischemic cardiomyopathy, n (%) 17 (89%) Donor Men, n (%) 13 (65%) Age (years) 29 ± 7.6 Body surface area (m 2 ) 1.78 ± 1.4 Current smoker, n (%) 0 (0%) Data shown as mean ± SD or n (%). Number of patients = 19. HTx: heart transplantation. Discussion In this retrospective analysis of 170 matched echocardiograms and endomyocardial biopsies of post-HTx patients, our main finding was that moderate (2R) cellular rejection was associated with RV contractile dysfunction when assessed by RV GLS, as well as by conventional Figure 3 – Distribution of rejection on cardiac biopsies over RV GLS strain results after heart transplantation. –20.6 ± 4.9 –23 ± 4.4 p = 0.038 –10 –20 –30 –15 –25 –35 RV global longitudinal strain (%) 0/1R 2R echocardiographic parameters such as TAPSE, S wave, and FAC. Conversely, LV systolic function was unchanged in this group. In addition, moderate rejection was associated with increased LV posterior wall thickness, E/e’ ratio, and E/A ratio. In the search for noninvasive methods to aid in screening for cellular rejection, a few studies evaluated strain and strain rate 641