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Related Experiment Videos

Diastolic dysfunction during acute cardiac allograft rejection.

I Amende1, R Simon, A Seegers

  • 1Division of Cardiology, Medical University, Hannover, FRG.

Circulation
|February 1, 1990
PubMed
Summary
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Acute cardiac rejection in heart transplant patients impairs left ventricular diastolic function, decreasing end-diastolic volume and peak filling rate, while systolic function remains relatively preserved.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Medical Imaging

Background:

  • Acute rejection is a significant complication following heart transplantation.
  • Assessing left ventricular function is crucial for monitoring transplant recipients.
  • Diastolic dysfunction can precede or accompany systolic impairment.

Purpose of the Study:

  • To evaluate left ventricular diastolic function during acute rejection in heart transplant patients.
  • To correlate echocardiographic and intramyocardial marker data with biopsy findings.
  • To compare diastolic and systolic parameters during rejection and post-treatment.

Main Methods:

  • Echocardiography and surgically implanted intramyocardial tantalum markers were used in 41 heart transplant patients.

Related Experiment Videos

  • Isovolumic relaxation time was measured from M-mode tracings.
  • End-diastolic volume, stroke volume, and peak filling rate were assessed using biplanar cineradiography.
  • Biopsy findings were correlated with functional measurements.

    • Main Results:

    • Acute rejection significantly decreased isovolumic relaxation time (107 to 65 msec) and end-diastolic volume (166 to 153 ml).
    • Peak filling rate was reduced (514 to 460 ml/sec) during rejection.
    • Stroke volume decreased (76 to 67 ml), but ejection fraction and end-systolic volume remained unchanged.
    • These diastolic changes resolved after immunosuppressive therapy.

    Conclusions:

    • Acute cardiac rejection primarily affects left ventricular diastolic function.
    • Diastolic alterations during rejection resemble those seen in restrictive cardiomyopathy.
    • Systolic performance is relatively preserved during acute rejection episodes.