Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography

Aim: to identify predictors of humoral rejection at different stages using non-invasive methods of 2D-speckletracking echocardiography, to determine the correlation with immunological changes.Materials and methods. The study was conducted on the basis of Regional Clinic Hospital of Krasnodar from 20...

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Main Authors: L. K. Tkhatl, T. V. Stavenchuk, E. D. Kosmachova, I. A. Pashkova
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2019-05-01
Series:Вестник трансплантологии и искусственных органов
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Online Access:https://journal.transpl.ru/vtio/article/view/988
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author L. K. Tkhatl
T. V. Stavenchuk
E. D. Kosmachova
I. A. Pashkova
author_facet L. K. Tkhatl
T. V. Stavenchuk
E. D. Kosmachova
I. A. Pashkova
author_sort L. K. Tkhatl
collection DOAJ
description Aim: to identify predictors of humoral rejection at different stages using non-invasive methods of 2D-speckletracking echocardiography, to determine the correlation with immunological changes.Materials and methods. The study was conducted on the basis of Regional Clinic Hospital of Krasnodar from 2010 to 2017. The analysis of 181 heart recipients was performed. 5 groups were allocated due to the crisis of humoral rejection and the identified antibodies to donor leukocyte antigens (HLA antibodies): group 1 (n = 10) – DSA and humoral rejection, group 2 (n = 7), patients with non-DSA and humoral rejection, group 3 (n = 17) – patients with antibodies to HLA, no humoral rejection, group 4 (n = 11), humoral crisis of rejection, with no identified HLA antibodies, group 5 (n = 87) – patients do not have antibodies to HLA and signs of both humoral and cellular rejection according to EMB. Recipients were carried out endomyocardial biopsy, immunological study, 2D-speckle-tracking echocardiography, statistical methods.Results. The diagnostic criteria for a humoral rejection is greater than 1 degree are global peak systolic strain or strain rate of left ventricle (GLPSLV) – 9.94 ± 1.37% (the sensitivity was 86.2%, specificity – 90.4%); radial systolic strain (RadSLV) of 19.36 ± 3.66% (sensitivity was 75.8%, specificity – 84.5%); circumferential systolic strain (CiRSLV) – 17.83 ± 4.79% (sensitivity was 78.6%, specificity – 84.4%); the twisting of the left ventricle (twist) – 8.90 ± 1.85% (sensitivity – 66.7%, specificity – 94.2%), p < 0.001. When considering indicators GLPSLV and longitudinal peak strain of the right ventricle (GLPSRV) in the diagnosis of humoral rejection sensitivity increases to 91.9%, specificity increases to 94.6%, p < 0.001.Conclusion. GLPSLV has greater sensitivity at the stage of subclinical changes. It is more significantly reduced with increasing degree of rejection associated with episodes of rejection in comparison with other parameters and deformation mechanics. The interrelation between histological and immunological changes and impaired myocardial deformation. The proposed diagnostic algorithm will predict humoral rejection.
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issn 1995-1191
language Russian
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publisher Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
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spelling doaj-art-17c083a0274d47208551883cbe5d4d742025-08-20T03:59:52ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912019-05-01211465610.15825/1995-1191-2019-1-46-56758Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiographyL. K. Tkhatl0T. V. Stavenchuk1E. D. Kosmachova2I. A. Pashkova3State Budget Health Care Institution «Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1»; Kuban State Medical UniversityState Budget Health Care Institution «Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1»; Kuban State Medical UniversityState Budget Health Care Institution «Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1»; Kuban State Medical UniversityState Budget Health Care Institution «Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1»; Kuban State Medical UniversityAim: to identify predictors of humoral rejection at different stages using non-invasive methods of 2D-speckletracking echocardiography, to determine the correlation with immunological changes.Materials and methods. The study was conducted on the basis of Regional Clinic Hospital of Krasnodar from 2010 to 2017. The analysis of 181 heart recipients was performed. 5 groups were allocated due to the crisis of humoral rejection and the identified antibodies to donor leukocyte antigens (HLA antibodies): group 1 (n = 10) – DSA and humoral rejection, group 2 (n = 7), patients with non-DSA and humoral rejection, group 3 (n = 17) – patients with antibodies to HLA, no humoral rejection, group 4 (n = 11), humoral crisis of rejection, with no identified HLA antibodies, group 5 (n = 87) – patients do not have antibodies to HLA and signs of both humoral and cellular rejection according to EMB. Recipients were carried out endomyocardial biopsy, immunological study, 2D-speckle-tracking echocardiography, statistical methods.Results. The diagnostic criteria for a humoral rejection is greater than 1 degree are global peak systolic strain or strain rate of left ventricle (GLPSLV) – 9.94 ± 1.37% (the sensitivity was 86.2%, specificity – 90.4%); radial systolic strain (RadSLV) of 19.36 ± 3.66% (sensitivity was 75.8%, specificity – 84.5%); circumferential systolic strain (CiRSLV) – 17.83 ± 4.79% (sensitivity was 78.6%, specificity – 84.4%); the twisting of the left ventricle (twist) – 8.90 ± 1.85% (sensitivity – 66.7%, specificity – 94.2%), p < 0.001. When considering indicators GLPSLV and longitudinal peak strain of the right ventricle (GLPSRV) in the diagnosis of humoral rejection sensitivity increases to 91.9%, specificity increases to 94.6%, p < 0.001.Conclusion. GLPSLV has greater sensitivity at the stage of subclinical changes. It is more significantly reduced with increasing degree of rejection associated with episodes of rejection in comparison with other parameters and deformation mechanics. The interrelation between histological and immunological changes and impaired myocardial deformation. The proposed diagnostic algorithm will predict humoral rejection.https://journal.transpl.ru/vtio/article/view/988humoral rejectiondonor specific anti-hla antibodiesmyocardial deformationglobal peak systolic strain2d-speckle-tracking echocardiography
spellingShingle L. K. Tkhatl
T. V. Stavenchuk
E. D. Kosmachova
I. A. Pashkova
Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
Вестник трансплантологии и искусственных органов
humoral rejection
donor specific anti-hla antibodies
myocardial deformation
global peak systolic strain
2d-speckle-tracking echocardiography
title Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
title_full Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
title_fullStr Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
title_full_unstemmed Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
title_short Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography
title_sort criteria for diagnosis of humoral rejection using the method of 2d speckle tracking echocardiography
topic humoral rejection
donor specific anti-hla antibodies
myocardial deformation
global peak systolic strain
2d-speckle-tracking echocardiography
url https://journal.transpl.ru/vtio/article/view/988
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AT edkosmachova criteriafordiagnosisofhumoralrejectionusingthemethodof2dspeckletrackingechocardiography
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