Abstract:
BACKGROUND:Endomyocardial biopsy (EMB) is the gold standard method for the diagnosis of cellular rejection (CR) after heart transplantation (HT). OBJECTIVE:To test the hypothesis that tissue Doppler imaging (TDI) could detect CR > 3A and add diagnostic information compared to conventional Doppler. METHODS:Fifty-four HT patients underwent 129 EMB and a TDI echocardiographic study within 24 hours. We compared HT patients with CR > 3A versus HT patients with CR < 3A, with a normal matched control group (13 patients). We measured TDI systolic (S), early diastolic (e'), late diastolic (a') velocities and e'/a' ratio in the left ventricular annulus, basal and medium (mid) segments of the septal (SEP), lateral (LAT), inferior (INF), anterior (ANT) walls; and in the right ventricular annulus. RESULTS:HT patients showed CR > 3A in 39/129 (30.2%) EMB. The best isolated predictor for CR diagnosis was a'LAT, with a sensitivity of 76.3%, specificity of 73.8% (p = 0.001). In the multivariate analysis, a'LAT (p = 0.001), a'SEP (p = 0.002), e'/a' LAT ratio (p = 0.006), e'Mitral/ e'LAT ratio (p = 0.014), SINF (p = 0.009) predicted CR > 3A. We obtained a score with a sensitivity of 88.2%, accuracy of 79.6% and negative predictive value of 92.9% to diagnose CR > 3A. Conventional Doppler (mitral and pulmonary venous flow) was not relevant to predict CR > 3A. CONCLUSION:TDI added diagnostic information to predict CR > 3A compared to conventional Doppler. A TDI-based model could become a potential method to detect CR > 3A after heart transplantation.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
Resende MV,Vieira ML,Bacal F,Andrade JL,Stolf NA,Bocchi EAdoi
10.1590/s0066-782x2011005000060subject
Has Abstractpub_date
2011-07-01 00:00:00pages
8-16issue
1eissn
0066-782Xissn
1678-4170pii
S0066-782X2011005000060journal_volume
97pub_type
杂志文章abstract:BACKGROUND:Due to the hemiparesis, the assessment of cardiorespiratory fitness on individuals after cerebrovascular accident (CVA), using exercise tests with conventional protocols, has become a challenge. OBJECTIVE:Perform cardiopulmonary test (CPT) in hemiparetic patients to a pre-participation evaluation aimed at a...
journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
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journal_title:Arquivos brasileiros de cardiologia
pub_type: 杂志文章
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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journal_title:Arquivos brasileiros de cardiologia
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