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Master Thesis

Non invasive diagnosis of acute rejection in patients with heart transplantation: contribution of echocardiography, cardiac MRI and biology

Abstract : Acute rejection, cellular or humoral, is one of main principal complications of heart transplant. The Gold standard for its diagnosis is endomyocardial biopsy (EBM), which is an invasive exam. Objective: the aim of our investigation is to examine contribution of non invasive exams used in routine: cardiac ultrasound, biology (sST2, troponin and NT-pro-BNP) and cardiac MRI, to diagnose as early as possible acute rejection, humoral and/or cellular, and its severity. Methods: all patients with heart transplant admitted for EBM at Montpellier UHC were included, prospectively. A transthoracic echography (TTE) and/or a blood sample with troponin, NT-pro-BNP and/or sST2 were also performed. Cardiac MRI was carried out at six weeks, six months and one year of transplantation. Results: between september 2019 and june 2020, 124 EBM were performed in 61 patients. 27 EBM highlighted an acute rejection (21.7%.) Patients with acute rejection have significantly lower left ventricular ejection fraction (59.60 ±8.61 versus 64.03 ±7.45; p= 0.02) and LGS (-13.29 ± 2.08 versus -14.46 ± 2.36, p= 0.05.) Among MRI data, involvement of septal territory in T1 mapping abnormalities is statistically more common in patients with acute rejection than in patients without rejection (71.4% versus 15.8%; p= 0.01.) Biological parameters values are similar in the two groups. Conclusion: LGS in TTE and T1 mapping in cardiac MRI seem to be interesting tools in early detection of acute rejection and could be used to guide EBM realization.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03104214
Contributor : Scd Université de Montpellier <>
Submitted on : Friday, January 8, 2021 - 4:56:59 PM
Last modification on : Saturday, July 3, 2021 - 3:16:33 AM

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  • HAL Id : dumas-03104214, version 1

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Anne-Sophie Rouviere. Non invasive diagnosis of acute rejection in patients with heart transplantation: contribution of echocardiography, cardiac MRI and biology. Human health and pathology. 2020. ⟨dumas-03104214⟩

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