Status: Funded - Open
2D speckle tracking echocardiography for non-invasive surveillance of rejection and coronary disease in pediatric heart transplant recipients
Justin Godown, MD
BACKGROUND: Rejection and coronary vasculopathy are among the leading causes of death and late graft loss in pediatric heart transplant recipients. Cardiac catheterization remains the diagnostic test of choice to detect these graft complications, but it is invasive and carries inherent risks that are magnified in small patients. For this reason, a reliable non-invasive method to detect rejection and coronary vasculopathy is highly desirable.
GAP: 2D speckle tracking echocardiography is an emerging technology that provides an angle-independent measure of myocardial deformation. Multiple small studies and case reports have demonstrated the potential utility of speckle tracking echocardiography in the detection of rejection and coronary vasculopathy; however, this technology has not been well-studied in the pediatric population.
HYPOTHESIS: The central hypothesis of this project is that speckle tracking echocardiography will allow earlier detection of both rejection and coronary vasculopathy compared to traditional measures of ventricular function.
METHODS: This is a retrospective study assessing serial echocardiograms on pediatric heart transplant recipients using 2D speckle tracking technology. Strain measurements by speckle tracking echocardiography will be compared to traditional measures of ventricular function when assessed longitudinally prior to episodes of rejection or the diagnosis of coronary vasculopathy.
IMPACT: The invasive nature of catheterization prohibits frequent screening, possibly leading to a delay in the diagnosis of graft complications. If speckle tracking echocardiography is proven to be a reliable non-invasive method to diagnose rejection and/or coronary vasculopathy, screening could be performed more safely and at more frequent intervals. This may result in earlier detection and treatment of graft complications, which could improve patient outcomes.