[Doppler echocardiographic evaluation of heart transplantation]

In order to evaluate major Doppler-Echocardiographic parameters for the diagnosis of acute cardiac allograft rejection episodes a serial of 54 Doppler Echocardiograms were performed simultaneously with endomyocardial biopsy in five patients (mean age = 40.2 y/o). Measurements included: right and left chambers diameters, left ventricular (LV) myocardial diastolic thickness, LV systolic function parameters, LV mass, LV volume/mass ratio, LV isovolumic relaxation time, mitral flow peak velocities and pressure half-time. Episodes with acute rejection histopathologic findings, Billingham class III or IV, were associated to increase in LV free wall thickness and LV mass (p less than 0,005) as well as decreased isovolumic relaxation time and pressure half-time (p less than 0,001). Left ventricular systolic function parameters and heart rate were no different comparing rejection and no rejection episodes. However, in each patient, progressive lower values of LV ejection fraction were associated to higher incidence of acute rejection episodes. Isovolumic relaxation time increased promptly following immunosuppressive therapy. Thus, Doppler Echocardiography is a reliable method for early detection of acute cardiac allograft rejection and monitoring of the cardiac transplant recipient.