• Hemamalini Palani and Govini Balasubramani.
• Institute of Heart and Lung Transplantation, Gleneagles Global Health City, Chennai, India. Electronic address: drhema07@yahoo.com.
• J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 3010-3020.

ObjectivesThis study sought to determine the utility of donor left ventricular function assessment by echocardiographic left ventricular global longitudinal strain (LV GLS) in predicting primary graft failure (PGF) after orthotopic heart transplantation (HT).DesignRetrospective, observational study.SettingTertiary referral hospital.ParticipantsAdult patients (>18 years) who underwent isolated HT.InterventionsDemographic, clinical, and echocardiographic data were collected on 100 patients who underwent HT between January 2010 and December 2019 at the authors' institution. The respective donor variables, as well as procedural factors, were reviewed and analyzed to assess their independent association with PGF. Standard donor echocardiographic measurements were supplemented by two-dimensional speckle-tracking echocardiography to obtain LV GLS. PGF was defined as per the International Society for Heart and Lung Transplantation 2014 consensus statement.Measurements And Main ResultsPGF occurred in 40 of the 100 patients (40%). Initial univariate analysis found that RADIAL score, donor ejection fraction, and donor LV GLS were associated with PGF. However, in a multivariate Cox regression analysis, only RADIAL score and donor LV GLS remained significant predictors of PGF, with a p < 0.001. By receiver operating characteristic curve analysis, LV GLS at a cut-off value of -11.5% showed the greatest area under the curve (area under the curve = 0.889; 95% confidence interval, 0.826-0.952) and predicted PGF with 92.5% sensitivity and 65% specificity.ConclusionsImpaired donor LV GLS was proven to be an independent predictor of PGF after HT.Copyright © 2021 Elsevier Inc. All rights reserved.

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