Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation
Background: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outc...
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Elsevier
2025-08-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S295013342500103X |
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| author | Grunde Gjesdal, MD PhD Anna Székely, MD Henrik Engblom, MD PhD Håkan Arheden, MD PhD Oscar Ö Braun, MD PhD Katarina Steding-Ehrenborg, RPT PhD |
| author_facet | Grunde Gjesdal, MD PhD Anna Székely, MD Henrik Engblom, MD PhD Håkan Arheden, MD PhD Oscar Ö Braun, MD PhD Katarina Steding-Ehrenborg, RPT PhD |
| author_sort | Grunde Gjesdal, MD PhD |
| collection | DOAJ |
| description | Background: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outcomes in patients with heart failure. We aimed to assess if longitudinal pumping is altered, if LVAVPD is associated with exercise capacity, and if any difference in longitudinal pumping could be explained by the presence of a right bundle branch block (RBBB) in heart-transplanted patients. Method: This single-center study included 34 heart-transplanted patients who had undergone CMR and a cardiopulmonary exercise test as part of a clinical post-transplant surveillance program. Data was compared to 34 healthy sex- and age-matched controls. Results: Heart-transplanted patients had decreased LVAVPD (10.3 vs 13.7 mm, p < 0.01), lower longitudinal contribution (46% vs 53%, p < 0.01), and lower septal contribution (−3% vs 8%, p < 0.01) to stroke volume compared to controls. Furthermore, the lateral contribution was increased (44% vs 28%, p < 0.01) in the heart-transplanted patients. Longitudinal contribution to stroke volume was neither associated with exercise capacity (p = 0.20) nor cardiac output at rest (p = 0.62). There was no difference in LVAVPD in patients with and without RBBB (p = 0.81). Conclusion: Heart-transplanted patients have decreased left ventricular longitudinal function compared to healthy controls, in part compensated by an augmented lateral function. Longitudinal function is not associated with cardiac output at rest or exercise capacity in this patient group. Whether the altered pumping mechanics seen are associated with outcome remains to be investigated. |
| format | Article |
| id | doaj-art-9cc45d6a40114158a4306b6be0a1bcf1 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-9cc45d6a40114158a4306b6be0a1bcf12025-08-20T03:41:57ZengElsevierJHLT Open2950-13342025-08-01910030810.1016/j.jhlto.2025.100308Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantationGrunde Gjesdal, MD PhD0Anna Székely, MD1Henrik Engblom, MD PhD2Håkan Arheden, MD PhD3Oscar Ö Braun, MD PhD4Katarina Steding-Ehrenborg, RPT PhD5Department of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, Sweden; Corresponding author: Grunde Gjesdal, MD, Section for Heart Failure and Valvular Disease, Department of Heart and Lung Medicine, Skåne University Hospital, 221 85, Lund, Sweden.Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Clinical Physiology, Skåne University Hospital, Lund, SwedenClinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Clinical Physiology, Skåne University Hospital, Lund, SwedenClinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Clinical Physiology, Skåne University Hospital, Lund, SwedenDepartment of Cardiology, Clinical Sciences, Lund University and Skåne University Hospital, Lund, SwedenClinical Physiology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Department of Clinical Physiology, Skåne University Hospital, Lund, SwedenBackground: In healthy hearts, left ventricular atrioventricular plane displacement (LVAVPD) measured by cardiac magnetic resonance (CMR) contributes to ∼60% of stroke volume. LVAVPD has been shown to correlate with maximal cardiac output and exercise capacity and is an independent predictor of outcomes in patients with heart failure. We aimed to assess if longitudinal pumping is altered, if LVAVPD is associated with exercise capacity, and if any difference in longitudinal pumping could be explained by the presence of a right bundle branch block (RBBB) in heart-transplanted patients. Method: This single-center study included 34 heart-transplanted patients who had undergone CMR and a cardiopulmonary exercise test as part of a clinical post-transplant surveillance program. Data was compared to 34 healthy sex- and age-matched controls. Results: Heart-transplanted patients had decreased LVAVPD (10.3 vs 13.7 mm, p < 0.01), lower longitudinal contribution (46% vs 53%, p < 0.01), and lower septal contribution (−3% vs 8%, p < 0.01) to stroke volume compared to controls. Furthermore, the lateral contribution was increased (44% vs 28%, p < 0.01) in the heart-transplanted patients. Longitudinal contribution to stroke volume was neither associated with exercise capacity (p = 0.20) nor cardiac output at rest (p = 0.62). There was no difference in LVAVPD in patients with and without RBBB (p = 0.81). Conclusion: Heart-transplanted patients have decreased left ventricular longitudinal function compared to healthy controls, in part compensated by an augmented lateral function. Longitudinal function is not associated with cardiac output at rest or exercise capacity in this patient group. Whether the altered pumping mechanics seen are associated with outcome remains to be investigated.http://www.sciencedirect.com/science/article/pii/S295013342500103XHeart transplantCardiac magnetic resonance imagingLeft ventricular atrioventricular plane displacementLongitudinal heart functionLongitudinal contribution to stroke volume |
| spellingShingle | Grunde Gjesdal, MD PhD Anna Székely, MD Henrik Engblom, MD PhD Håkan Arheden, MD PhD Oscar Ö Braun, MD PhD Katarina Steding-Ehrenborg, RPT PhD Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation JHLT Open Heart transplant Cardiac magnetic resonance imaging Left ventricular atrioventricular plane displacement Longitudinal heart function Longitudinal contribution to stroke volume |
| title | Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| title_full | Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| title_fullStr | Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| title_full_unstemmed | Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| title_short | Left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| title_sort | left ventricular longitudinal function is reduced but partially compensated by increased radial function after heart transplantation |
| topic | Heart transplant Cardiac magnetic resonance imaging Left ventricular atrioventricular plane displacement Longitudinal heart function Longitudinal contribution to stroke volume |
| url | http://www.sciencedirect.com/science/article/pii/S295013342500103X |
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