Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

Logo MUG-Forschungsportal

Gewählte Publikation:

Grasser, B; Iberer, F; Schreier, G; Schaffellner, S; Kleinert, R; Prenner, G; Kastner, P; Hutten, H; Tscheliessnigg, K.
Non-invasive cardiac allograft monitoring: the graz experience.
J Heart Lung Transplant. 2000; 19(7):653-659
Web of Science PubMed

 

Autor/innen der Med Uni Graz:
Iberer Florian
Kleinert Reinhold
Prenner Günther
Schaffellner Silvia
Tscheliessnigg Karlheinz
Altmetrics:

Dimensions Citations:

Plum Analytics:
Abstract:
Based on previous reports by our group, initial studies on non-invasive cardiac graft monitoring have been presented recently. In this study we define new parameters to monitor rejection and infection after heart transplantation (HTX) the ventricular evoked response (VER) T-slew rate parameter is defined as the maximum negative slope in the descending part of the repolarization phase of the VER. We calculated the VER duration parameter in milliseconds and defined it as the time between the pacemaker spike and the cross-over of the baseline, with the slope line used to calculate the VER T-slew rate. During the HTX procedure, we implant wide-band telemetric pacemakers and fractally coated, epimyocardial electrodes (Physios CTM 01 and ELC 54-UP, Biotronik; Berlin, Germany). During each follow-up and on biopsy days, intramyocardial electrogram sequences were obtained and sent via the Internet to the central data-processing unit in Graz. We scored the infection status of the patients before data acquisition. The VER parameters were automatically calculated and send back within a few minutes. We prospectivly compared 1,613 follow-ups from 42 patients with biopsy (International Society of Heart and Lung Transplantation grading) and infection classification. The VER duration parameter did not change during rejection; however, we found an increase during clinically apparent infection. The VER T-slew rate parameter was lower during rejection grade 2 or higher, as well as during clinically apparent infection. The negative predictive value to rule out rejection was 99%. Our results indicate that rejection and infection cause different, reproducible effects on the electrical activity of the transplanted heart. Non-invasive cardiac graft monitoring may reduce the need for surveillance biopsies and may offer a tool to optimize immunosuppressive therapy after HTX.
Find related publications in this database (using NLM MeSH Indexing)
Action Potentials - physiology
Adolescent -
Adult -
Aged -
Electrodes, Implanted -
Electrophysiology - instrumentation Electrophysiology - methods
Graft Rejection - diagnosis
Heart Transplantation - physiology
Humans -
Middle Aged -
Prognosis -
Prospective Studies -
Sensitivity and Specificity -
Telemetry -
Transplantation, Homologous - physiology

© Meduni Graz Impressum