[Hemodynamic features of cardiac rejection]

The object of this investigation was to demonstrate the hemodynamic features of cardiac rejection. The postoperative functional evolution of a homogeneous group of unmodified homografts was compared with that of a group of autografts studied by the same protocol. On the 4th postoperative day, a significant decrease was observed initially in the maximum systolic output, the maximum systolic rate index, the mean systolic ejection rate and also in the strength, work and, especially, acceleration of the left ventricles of the homografts. In the terminal phase, the abnormalities already present in these parameters worsened; there was a large decrease in cardiac output, in the stroke volume, in the voltage of the electrocardiogram, and a slowdown in cardiac emptying. During terminal heart failure, the aortic pressure became depressed and the central venous pressure increased rapidly. The hemodynamic reaction following the homoplastic graft was totally different after the 4th day. The comparison of the results obtained from these two experimental groups established that the functional cardiac failure described for the homoplastic transplant represents the hemodynamic expression of acute rejection.