PMC1397870_01
The force-frequency curve with DIP stress echo in the Donor heart. Upper panel: An increased heart rate is accompanied by smaller end-systolic volumes (normal up sloping FFR). The pressure/volume relation was 9.6 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, FFR slope = 28 mmHg/ml/m2/bpm demonstrating absence of latent myocardial dysfunction. Middle and lower panels. Systemic blood pressure and LVEF % at baseline and peak stress. A stress induced increase in LVEF simultaneously to stress induced systolic and diastolic pressure decrease is confounding for the contractile reserve evaluation.
1476-7120-4-3-2.jpg
PMC1397870_01_1476-7120-4-3-2.jpg
F2
PMC1397870_02
Two-dimensional transthoracic echocardiogram recorded in the marginal recipient with cardiac amyloid. In both the parasternal long-axis (right) and apical four-chamber (left) images note the homogeneous echo intensity of the myocardium, which is noted as a bright "speckling" appearance. Both the mitral and aortic valves are also thickened. The patient had severe ventricular dysfunction and advanced heart failure symptoms (NYHA Class IV). (Images from Marinella Ferlito, Director Echo lab, and Prof Claudio Rapezzi, University Cardiology Division, S. Orsola Hospital, Bologna, Italy) Additional files (video clips) 5 and 6. Two-dimensional transthoracic echocardiogram of the donor heart grafted in the marginal recipient. In both the parasternal long-axis (Additional file 5) and apical four-chamber (Additional file 6) views note the excellent global and regional ventricular function. Chambers and cardiac structures are normals. (Images from Marinella Ferlito, Director Echo lab, and Prof Claudio Rapezzi, University Cardiology Division, S. Orsola Hospital, Bologna, Italy)
1476-7120-4-3-3.jpg
PMC1397870_02_1476-7120-4-3-3.jpg
F3
He was a 63 year old man with multiple myeloma and cardiac amyloidosis, chronic severe heart failure, NYHA class IV, LVEF = 13% (TT echocardiography, Figure 3).
Graft coronary artery imaging- appearance by angiography and intravascular ultrasound 1 month after follow-up. Excellent angiographic result demonstrating concordance with the pre-transplant potential donor stress echo (no inducible ischemia). The left panel shows angiogram obtained on the transplanted heart 1 month after engraftment. Angiographic imaging of the midportion of the LAD only shows minor lumen irregularities within the vessel. The right panel shows intravascular ultrasound images obtained in the same coronary segment. (images from Prof Claudio Rapezzi and Dr Carlo Magelli, responsible of the Clinical Heart Transplant Program, University Cardiology Division, S. Orsola Hospital, Bologna, Italy)
1476-7120-4-3-4.jpg
PMC1397870_02_1476-7120-4-3-4.jpg
F4