Doppler echocardiography for the diagnosis of acute cardiac allograft rejection

Desruennes, M; Corcos, Thierry; Cabrol, A; Gandjbakhch, I; Pavie, Alain; Léger, Philippe; Eugène, Michel; Bors, V.; Cabrol, C

doi:10.1016/0735-1097(88)90357-9

Cited by 101 publications

(29 citation statements)

References 26 publications

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“…Rejection detection included clinical evaluation, pulsed Doppler echography, and right endomyocardial biopsy ( 7). Rejection was assessed on myocardial biopsy (3) according to the grading system of Billingham (I light, I1 mild, I11 moderate, IV severe).…”

Section: Bioclinical Follow Upmentioning

confidence: 99%

Lipoproteins in heart transplantation: Proton magnetic resonance spectroscopy of plasma

Moyec

Certaines

Desruennes

et al. 1991

Magnetic Resonance in Med

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Despite the major improvement in immunosuppressive therapy, noninvasive detection of heart graft rejection remains a challenge. As lipoproteins are involved in several immunomodulation mechanisms, we studied their proton NMR spectra in plasma from patients after heart transplantation. NMR data were compared to clinical and functional evaluation of rejection process. The total linewidth (TLW) of methyl and methylene peaks, mainly arising from lipoproteins, were significantly lower for patients without a rejection process than for patients before surgery and patients with evidences of a rejection process. When TLW values are referred to TLW on the 8th day for each patient, the sensitivity and the specificity of the test are increased, with resulting positive and negative predictive values of 90 and 91%, respectively. The results obtained on more than 400 samples from 46 patients justify the use of proton NMR spectroscopy as a clinical tool.

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Section: Bioclinical Follow Upmentioning

confidence: 99%

Lipoproteins in heart transplantation: Proton magnetic resonance spectroscopy of plasma

Moyec

Certaines

Desruennes

et al. 1991

Magnetic Resonance in Med

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“…The interval was then increased to 2 weeks during months 2 through 6, and to 2 months in the following 6 months [8].…”

Section: Methodsmentioning

confidence: 99%

A prospective-randomized controlled study on the efficacy and tolerance of two antilymphocytic globulins in the prevention of rejection in first-heart transplant recipients

Schnetzler¹,

Léger²,

Völp³

et al. 2002

Transplant Int

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The usefulness of induction phase treatment in heart transplantation is a long‐standing debate in the literature. Several centers report good short‐term survival without such treatment, but no randomized trial addresses this question. If induction treatment is to be used, most centers prefer rabbit polyclonal antisera to OKT3. However, again, no randomized trial has compared the relative efficacy and tolerance of rabbit antisera. Fifty first‐heart transplant recipients with standard triple immunosuppression were randomized to receive ATG Fresenius (n=24) or Thymoglobulin Mérieux (n=26) as an induction treatment and were followed for 1 year. The two groups were well matched for gender, age, pre‐transplant diagnosis and ischemia time. Actuarial survival at 1 year was 87.5% in the Fresenius group and 84.6% in the Mérieux group (Fisher's exact test; P=1). The average number of rejection episodes per patient was comparable in both treatment groups (Fresenius: mean = 2.63, SD = 1.44; Mérieux: mean = 2.46, SD = 2.04). Mean time to first rejection was 48.9±37.2 days in the Fresenius group versus 59.6±54 days in the Mérieux group (Mann‐Witney U‐test: z=0.77; P=NS). The total number of rejections across all patients was also comparable (Fresenius: 63; Mérieux: 64) as well as the severity of rejection (seven moderate rejections out of a total of 63 in the Fresenius group and eight out of 64 in the Mérieux group). Eighteen Fresenius (75%) and 15 Mérieux (58%) patients suffered from at least one infection (P=NS). The tolerance to treatment was excellent in both groups. Total lymphocyte count and all subsets of tested lymphocytes decreased rapidly after the introduction of either antiserum but was more pronounced and persisted for longer in the Mérieux group. ATG Fresenius or Thymoglobulin Mérieux as induction treatments in first‐heart transplant recipients treated with standard immunosuppression have the same relative efficacy with regard to survival, acute rejection or infection rate, and are well tolerated.

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“…Abnormalities of left ventricu lar diastolic function were observed in left ventricular hypertrophy secondary to hyper tension or hypertrophic cardiomyopathy [9], ischemic heart disease [10], acute car diac allograft rejection [16], diabetic car diomyopathy [17] and doxorubicin cardiotoxicity [18]. In these diseases, the diastolic abnormalities often precede systolic dys function.…”

Section: Introductionmentioning

confidence: 99%

Doppler-Echo Evaluation of Left Ventricular Diastolic Filling in Patients with Mixed Connective Tissue Disease

Leung

Wong²,

Lau³

et al. 1990

Cardiology

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Left ventricular diastolic function was assessed in 17 patients (2 males and 15 females; mean age 44 ± 9 years) with mixed connective tissue disease (MCTD) and 18 sex-and age-matched healthy control subjects (2 males and 16 females; mean age 44 ± 8 years) by means of M-mode and pulsed Doppler echocardiography. None had clinical evidence of overt myocardial disease or abnormal left ventricular systolic function. Compared with the control group, patients with MCTD had a significantly longer isovolumic relaxation time (IVRT) (59 ± 7 versus 70 ± 12 ms; p < 0.01), a lower peak early diastolic flow velocity (E) (0.79 ± 0.10 versus 0.70 ± 0.07 m/s; p < 0.005), a higher peak late diastolic flow velocity due to atrial contraction (A) (0.47 ± 0.08 versus 0.54 ± 0.08 m/s; p < 0.05) and a reduced E/A ratio (1.72 ± 0.37 versus 1.33 ± 0.26; p < 0.005). Although there was no significant correlation of left ventricular diastolic filling indexes with age, heart rate, left ventricular end-diastolic and end-systolic dimensions, interventricular septal and left ventricular posterior wall thickness, and fractional shortening, the duration of illness was significantly related to IVRT (r = 0.62; p < 0.01), peak A (r = 0.79; p < 0.001) and velocity half-time (r = 0.54; p < 0.05). The results suggest the presence of an abnormal left ventricular diastolic filling pattern in patients with MCTD and may represent myocardial involvement in this disease.

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Doppler echocardiography for the diagnosis of acute cardiac allograft rejection

Cited by 101 publications

References 26 publications

Lipoproteins in heart transplantation: Proton magnetic resonance spectroscopy of plasma

Lipoproteins in heart transplantation: Proton magnetic resonance spectroscopy of plasma

A prospective-randomized controlled study on the efficacy and tolerance of two antilymphocytic globulins in the prevention of rejection in first-heart transplant recipients

Doppler-Echo Evaluation of Left Ventricular Diastolic Filling in Patients with Mixed Connective Tissue Disease

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