Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Transplantation
Volume 2014 (2014), Article ID 173589, 4 pages
http://dx.doi.org/10.1155/2014/173589
Case Report

Case of Acute Graft Failure during Suspected Humoral Rejection with Preserved Ejection Fraction, but Severely Reduced Longitudinal Deformation Detected by 2D-Speckle Tracking

1Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark
2Department of Clinical Immunology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark
3Department of Pathology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark

Received 27 January 2014; Revised 21 May 2014; Accepted 27 May 2014; Published 11 June 2014

Academic Editor: Laurent Sebbag

Copyright © 2014 Tor Skibsted Clemmensen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This case displays limited utility of left ventricular ejection fraction to detect acute graft failure due to microvascular vasculopathy and suspected humoral rejection. Despite severe and progressive graft failure, clinically and by right heart catheterizations, left ventricular ejection fraction remained unchanged, indicating need of more reliable noninvasive methods for graft function surveillance. Global longitudinal strain relates to clinical heart failure, filling pressure, and cardiac index during suspected humoral rejection and microvascular dysfunction in this HTX patient. We suggest routine monitoring of graft function by global longitudinal strain as supplement to routine left ventricular ejection fraction and diastolic Doppler measurements.