Application Of Right Ventricular Real-Time Three-Dimensional Echocardiography And Tissue Doppler Imaging In Detecting Allograft Rejection In Heart Transplants

PartⅠAssessment of Global and Segmental Right Ventricular Systolic Function in Normal Subjects Using Real-Time Three-Dimensional EchocardiographyObjectivesThis study was aimed to assess global and regional right ventricular systolic function using real-time three-dimensional echocardiography (RT3DE),and to obtain the normal ranges of right ventricular volume and ejection fraction in healthy subjects.MethodsThirty healthy subjects underwent RT3DE and the data were analyzed off-line.End-diastolic volume(RVEDV),end-systolic volume(RVESV) and ejection fraction(RVEF) of global and regional right ventricle were evaluated.ResultsRVEDV was(79.55±20.77) ml in normal subjects,RVEDV was (32.00±10.09) ml,RVSV was(47.45±12.82) ml,RVEF was(59.83±6.01) %.Regional volume decreased progressively from RV inflow tract,RV body to RV outflow tract.EF of RV body was lower than that of RV outflow and inflow tract(P＜0.01).ConclusionsReal-time three-dimensional echocardiography could assess global and segmental right ventricular systolic function.The systolic function was significantly different among three parts of right ventricular chamber. PartⅡApplication of Right Ventricular Real-Time Three-Dimensional Echocardiography and Tissue Doppler Imaging in Detecting Allograft Rejection in Heart TransplantsObjectivesIn order to evaluate the potential role of right ventricular echocardiography in detecting allograft rejection in heart transplant patients.MethodsThe heart transplant recipients were divided into rejection group(group A) and non-rejection group(group B),based on endomyocardial biopsy and clinical diagnosis.Then two-dimensional echocardiography and real-time three-dimensional echocardiography(RT3DE),pulse wave Doppler and tissue Doppler(TDI) were performed in heart transplant patients(group A and B) and controls(group C).RT3DE "full volume" imaging was acquired in four chamber view,then right ventricular end-diastolic volume(RVEDV), right ventricular end-systolic volume(RVESV) and right ventricle ejection fraction(RVEF) were calculated.ResultsLeft atrial diameter in group A and B was enlarger than that of group C. Left ventricular posterior wall thickness increased in group A and B.RVEF with RT3DE in group A was lower than those of group B and C(P＜0.01), RVSV in group A and B was lower than in group C(P＜0.05),EF of RV body and outflow tract were decreased significantly in group A(P＜0.05). TD systolic velocity in tricuspid annulus and right ventricular wall,velocity of peak A in group A were reduced significantly compared with those of group B and C(P＜0.05).There were correlations between RVEF with RT3DE and both right ventricular Tei index(r=0.592,P＜0.01) and TD-derived systolic velocity in tricuspid annulus and right ventricular wall(r=0.543,P＜0.01).ConclusionsRight ventricular systolic function deteriorated significantly in allograft rejection heart transplants compared with healthy subjects.And right ventricular systolic function decreased slightly in non-rejection recipients. Right ventricular EF with RT3DE and TD systolic velocity and velocity of peak A could be useful in detecting allograft rejection.