What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Heart transplant rejection (n=67). Intervention: Septal time to peak systolic velocity (septal Ts). Primary outcome: Heart transplant rejection (any grade of cellular rejection or antibody-mediated rejection) (OR 0.931, 95% CI 0.867-0.970, p=0.048).

What does this research mean for the field?

Higher septal time to peak systolic velocity in ejection phase (septal Ts) is significantly associated with reduced odds of heart transplant rejection and demonstrates good predictive accuracy with an AUC of 81.9%. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the predictive accuracy of echocardiographic and tissue Doppler imaging parameters for identifying heart transplant rejection in comparison with endomyocardial biopsy.

October 25, 2025American Heart Journal Plus Cardiology Research and PracticeOpen Access

Evaluation of the predictive value of echocardiography parameters for heart transplant rejection: A tissue Doppler imaging observational study

Q: What are the key findings of this study?

Higher septal time to peak systolic velocity (septal Ts) was significantly associated with a lower likelihood of heart transplant rejection (OR 0.931) and demonstrated an AUC of 81.9% for predicting rejection.

View Full Paper

Ask AI

Bookmark

Key result

Higher septal Ts is linked to ~7% lower risk of heart transplant rejection.

OR 0.931
95% CI 0.867-0.970
P=0.048
n=67

Why the study?

Due to drawbacks of endomyocardial biopsy, non-invasive methods are needed to assess heart transplant rejection.

Do echocardiographic parameters (septal Ts and E velocity) predict heart transplant rejection in adult heart transplant recipients?

Population

67 heart transplant patients with available EMB results in Iran

Comparison

Heart transplant rejection vs non-rejection

Design

Cross-sectional study

Authors

FGFereshteh GhaderiMashhad University of Medical Sciences HPHoorak PoorzandMashhad University of Medical Sciences FVFarveh VakilianMashhad University of Medical Sciences

Discussion

Member takes

Implication

Septal Ts may aid non-invasive rejection screening in transplant recipients; hypothesis-generating and requires prospective validation before practice change.

Key Points

To evaluate the predictive accuracy of echocardiographic and tissue Doppler imaging parameters for identifying heart transplant rejection in comparison with endomyocardial biopsy.
Conducted a cross-sectional study of 67 heart transplant recipients in Iran (mean age 39.20 ± 11.39 years; 50 male, 17 female) with available endomyocardial biopsy results.
Performed comprehensive echocardiography and tissue Doppler imaging on the same day prior to biopsy, assessing associations with rejection via binary logistic regression and ROC analyses.
Transplant rejection occurred in 22 of 67 patients (32.8%).
Septal time to peak systolic velocity (septal Ts) was significantly associated with rejection (OR = 0.931, 95% CI 0.867 to 0.970, p = 0.048), demonstrating an AUC of 81.9% (sensitivity 75%, specificity 69% at cut-off < 92.5 ms).
Mitral early diastolic flow (E) velocity was significantly associated with rejection (OR = 78.069, 95% CI 1.871 to 3257.226, p = 0.022), yielding an AUC of 68.6% (sensitivity 68%, specificity 61% at cut-off 0.65).

Study Design

Type

Cross-Sectional (n=67)

Multicenter

Structured PICO

Do echocardiographic parameters (septal Ts and E velocity) predict heart transplant rejection in adult heart transplant recipients?

Population

67 adult heart transplant recipients without signs of heart failure who underwent endomyocardial biopsy and same-day echocardiography.

Exposure

Echocardiography including tissue Doppler imaging (TDI) performed on the same day as endomyocardial biopsy, specifically assessing septal time to peak systolic velocity in ejection phase (septal Ts) and mitral inflow early diastolic flow (E).

Outcome

Heart transplant rejection, defined as any grade of cellular rejection (grade ≥1) or presence of antibody-related characteristics on endomyocardial biopsy.surrogate

Main Result

Odds Ratio: 0.931 (95% CI 0.867–0.97)

p-value: p=0.048

Septal time to peak systolic velocity (septal Ts) measured by tissue Doppler imaging is a useful non-invasive predictor of heart transplant rejection.

Limitations

Small sample size preventing subgroup analyses
Lack of older patients in the study cohort
Patchy nature of cellular rejection may lead to under-representation in localized echocardiographic sampling
Single-center study design
Need to assess the effect of the type of transplant surgery technique and different grades of rejection
Need for inclusion of older patients as the observed rejection pattern might be different in the elderly

Cite This Study

Ghaderi et al. (2025) conducted a cross-sectional in Heart transplant rejection (n=67). Septal time to peak systolic velocity (septal Ts) was evaluated on Heart transplant rejection (any grade of cellular rejection or antibody-mediated rejection) (OR 0.931, 95% CI 0.867-0.970, p=0.048). Higher septal time to peak systolic velocity (septal Ts) was significantly associated with a lower likelihood of heart transplant rejection (OR 0.931) and demonstrated an AUC of 81.9% for predicting rejection.

synapsesocial.com/papers/6a772a0ff6b553d308ae4e2f https://doi.org/10.1016/j.ahjo.2025.100654

View Full Paper

Ask AI

Bookmark

Implication

Septal Ts may aid non-invasive rejection screening in transplant recipients; hypothesis-generating and requires prospective validation before practice change.

Evaluation of the predictive value of echocardiography parameters for heart transplant rejection: A tissue Doppler imaging observational study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Evaluation of the predictive value of echocardiography parameters for heart transplant rejection: A tissue Doppler imaging observational study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider