Document Detail

Electrophysiologic parameters suggesting significant acute cellular rejection of the transplanted heart.
MedLine Citation:
PMID:  17025028     Owner:  NLM     Status:  MEDLINE    
AIM OF THE STUDY: Was to estimate an influence of acute cellular rejection on electrophysiologic parameters of allograft and remnants of recipient's heart, in patients after orthotopic heart transplantation (OHT). PATIENTS AND METHODS: Analysis was performed in 25 OHT recipients (24M/1F, age 48.4 +/- 9 y., ischemic time 197 +/- 51 min., donor age 30 +/- 9 y.), who underwent electrophysiological study (EPS), along with elective endomyocardial biopsy (EMB), scheduled for the 1st month after the surgery. Results of EPS were correlated with a degree of rejection, assessed with the ISHLT grading system. Grades > or =3A were considered a significant cellular rejection. RESULTS: ISHLT grade 0 was observed in 8 patients, grade 1A or 1B in 12 patients, and 3A in 5 patients. Frequency of transplanted heart rhythm (TH-R) was 691.3+/- 37 ms in patients with ISHLT grade 0, 690.4 +/- 41 ms in patients with grade 1A or 1B, and 744.4 +/- 668 ms in individuals with 3A rejection (p < 0.04, for difference between 0 and 3A groups). Intraatrial conduction time (IntrtaCT) was significantly shorter in grade 3A group (20.4 +/- 1.6 ms), when compared with patients without rejection (36.2 +/- 4.9 ms, p < 0.03), or with 1A or 1B rejection (41.5 +/- 13 ms, p < 0.032). Also interatrial conduction time (InterCT) was the shortest in patients with 3A rejection (53.8 +/- 4.3 ms), when compared with ISHLT grade 0 group (78.5 +/- 7.6 ms, p < 0.02) and 1A/1B group (74.1 +/- 12 ms, p < 0.023). The other characteristics of atria, ventricles and AV-junction performance were comparable in all patients. CONCLUSIONS: TH-R, IntraCT and InterCT should be considered as the markers of significant cellular rejection in patients after OHT. Further analysis involving higher number of patients is warranted.
Oskar Kowalski; Michał Zakliczyński; Radosław Lenarczyk; Janusz Prokopczuk; Patrycja Pruszkowska-Skrzep; Zbigniew Kalarus; Marian Zembala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  11     ISSN:  1425-9524     ISO Abbreviation:  Ann. Transplant.     Publication Date:  2006  
Date Detail:
Created Date:  2006-10-09     Completed Date:  2006-11-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  35-9     Citation Subset:  IM    
1st Dept. of Cardiology, Silesian Center for Heart Disease, Zabrze, Poland.
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MeSH Terms
Acute Disease
Coronary Vessels / physiology
Graft Rejection / physiopathology*
Heart Rate*
Heart Transplantation / pathology,  physiology*
Middle Aged

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