{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:31:28Z","timestamp":1760236288559,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Despite the risk for complications, allograft surveillance after orthotopic heart transplantation (OHT) is performed by cardiac catheterization and biopsies. We investigated the diagnostic and prognostic value of a TDI-derived systolic wall motion analysis of the posterobasal wall of the left ventricle (Sm) as a screening modality in OHT aftercare. Methods: We examined data of 210 eligible patients who underwent OHT between 2010 and 2020. Forty-four patients who had died within the initial hospital stay were excluded. For 166 patients, baseline and follow-up data were analyzed. The mean age at OHT was 46.2 (\u00b111.4) years; 76.5% were male. Results: Within the observational period, 22 (13.3%) patients died. In total, 170 episodes of acute cellular or humoral rejections occurred (84 ISHLT1R; 13 ISHLT2R; 8 ISHLT3R; 65 AMR), and 29 catheterizations revealed cardiac allograft vasculopathy (5 CAV1; 4 CAV2; 20 CAV3). Individual Sm radial\/longitudinal remained stable within the follow-up period (11.5 \u00b1 2.2 cm\/s; 10.9 \u00b1 2.1 cm\/s). Patients with acute rejections and CAV3 showed significant Sm radial\/longitudinal reductions (AMR1: 1.6 \u00b1 1.9 cm\/s, confidence interval (CI) 0.77\u20130.243, p &lt; 0.001; 1.8 \u00b1 2.0 cm\/s, CI 0.92\u20130.267, p &lt; 0.001. ISHLT1R: 1.7 \u00b1 1.8 cm\/s, CI 1.32\u20132.08, p &lt; 0.001; 2.0 \u00b1 1.6 cm\/s, CI 1.66\u20132.34, p &lt; 0.001. CAV3: 1.3 \u00b1 2.5 cm\/s, CI 0.23\u20132.43, p &lt; 0.017; 1.4 \u00b1 2.8 cm\/s, CI 0.21\u20132.66, p &lt; 0.021). Lower Sm was associated with a threefold increase in all-cause mortality (hazard ratio (HR) 3.24, CI 1.2\u20138.76, p = 0.020; HR 2.92, CI 1.19\u20137.18, p = 0.019). Overall, Sm-triggered surveillance led to 0.75 invasive diagnostics per patient post-OHT year. Conclusions: Sm remained stable in the post-OHT course. Reductions indicated ISHLT1R, AMR1 and CAV3 and were associated with higher all-cause mortality. Sm-triggered surveillance may be referred to as a safe, high-yield screening modality in OHT aftercare.<\/jats:p>","DOI":"10.3390\/life11111206","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T12:46:23Z","timestamp":1636461983000},"page":"1206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic and Prognostic Value of a TDI-Derived Systolic Wall Motion Analysis as a Screening Modality for Allograft Rejection after Heart Transplantation"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1141-9387","authenticated-orcid":false,"given":"Isabell A.","family":"Just","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meryem","family":"Guelfirat","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Leser","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ata","family":"Uecertas","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurenz","family":"Kopp Fernandes","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maren","family":"Godde","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Merke","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Stawowy","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"},{"name":"Department of Cardiology and Internal Medicine, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Hennig","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8127-5019","authenticated-orcid":false,"given":"Christoph","family":"Knosalla","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"},{"name":"Department of Cardiothorarcic Surgery, Charit\u00e9, Corpoate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00fct Berlin and Berlin Institute of Health, 13353 Berlin, Germany"},{"name":"Translational Cardiovascular Technologies, Department of Health Sciences, Eidgenoessische Technische Hochschule (ETH) Zurich, 8092 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-0016","authenticated-orcid":false,"given":"Jan","family":"Knierim","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-1295","authenticated-orcid":false,"given":"Felix","family":"Schoenrath","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, 13353 Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, 10785 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/j.healun.2019.08.001","article-title":"The International Thoracic-Organ-Transplant-Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report\u20142019; focus theme: Donor and recipient size match","volume":"38","author":"Chambers","year":"2019","journal-title":"J. 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Imaging"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/11\/11\/1206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:27:50Z","timestamp":1760167670000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/11\/11\/1206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":26,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["life11111206"],"URL":"https:\/\/doi.org\/10.3390\/life11111206","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2021,11,9]]}}}