Echocardiographic profile of the transplanted human heart in clinically well recipients

Thirty-four clinically well heart transplant recipients, aged 21 to 60 years, were selected for echocardiographic study at 12 ± 2 months after transplantation. All had normal findings at stress thallium scintigraphy and at radionuclide left ventriculography, and no endomyocardial biopsy evidence of rejection was found within 36 hours of study. Multiple echocardiographic measurements were compared with those from two control groups. The first control group consisted of 15 normal subjects of similar ages as the donors, and the second group consisted of 15 normal subjects of similar ages as the recipients. Left ventricular mass (193 ± 55 gm) was significantly increased in the transplant recipients compared with both control groups (p < 0.001). Left ventricular volumes and ejection fractions of the transplanted heart, however, were normal. Right ventricular diastolic wall thickness (0.6 ± 0.1 cm) and chamber area in both diastole (23.3 ± 3 cm²) and systole (15.7 ± 4 cm²) were significantly increased in the transplant patients (p < 0.001), but fractional area change was similar to that of the normal group. Both left atrial area (26.9 ± 4 cm²) and right atrial area (20.7 ± 4 cm²) were significantly increased in the transplant recipients (p < 0.001). One year after transplantation, clinically well recipients are characterized by increased left ventricular mass, but normal volumes and ejection fraction, increased right ventricular wall thickness and cavity size, but normal right ventricular systolic function, and markedly dilated atria.