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  • Title: [Noninvasive detection by Doppler and M-mode echocardiography of acute rejection reaction after heart transplantation: preliminary results of a prospective study].
    Author: Störk T, Walkowiak T, Siniawski H, Danne O, Müller R, Möckel M, Eichstädt H, Hetzer R, Hochrein H.
    Journal: Z Kardiol; 1990 Nov; 79(11):758-65. PubMed ID: 2278168.
    Abstract:
    Diagnosis of acute cardiac allograft rejection is still based on the results of endomyocardial biopsy. The objective of this study was to evaluate changes of left ventricular (LV) diastolic function associated with rejection using Doppler and M-mode echocardiography. The study patients, consisting of 29 cardiac allograft recipients (12 female, 17 male) aged 27 to 58 (mean 41) years, were classified into two groups on the basis of histopathologic findings: 13 patients without rejection (mean age 40 years) and 16 patients with moderate to severe allograft rejection (mean age 42 years) at myocardial biopsy. All patients underwent serial echocardiographic examination 4-10 weeks after transplantation and 8 +/- 2 days later on the day of myocardial biopsy. Twenty-five healthy volunteers (11 female, 14 male; mean age 39 years) served for assessing normal values. Echocardiographic assessment included peak velocity (PEV), pressure half-time (PHT), velocity-time integral (VTI-E) of early mitral flow (E-wave), and isovolumic relaxation period (IVRP). In transplant recipients, significantly higher values as compared to normals were found for PEV (72 vs 55 cm/s; p less than 0.01), PHT (51 vs 42 ms; p less than 0.001), VTI-E (71 vs 56 mm; p less than 0.001), and IVRP (91 vs 73 ms; p less than 0.001). During rejection, heart rate increased significantly from 78 to 93 beats/min (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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