Non-invasive cardiac allograft monitoring: the Graz experience

Computerized heart allograft-recipient monitoring: a multicenter study

“…It can, therefore, be expected that the results are not dependent on a very special kind of basic immunosuppression or rejection therapy regimen. The overall correlation between EMB results and IEGM results, however, was slightly lower than that in the previous single-center study [13], but this had to be expected because of (a) the prospective study design and (b) much more variability due to differences in patient management (EMB evaluation, therapy cut-off, immunosuppression, etc.). This notion is supported by additional analyses based on reference EMB grades, individual center diagnostic thresholds, and additional VER parameters, which were able to demonstrate somewhat higher diagnostic indices.…”

“…Eventually, other investigators obtained comparable results in similar studies [5,6,8,171. Recently, comprehensive results from our single-center experience have been reported [13]. In order that the possibility of a prospective and multicenter application of the proposed method could be assessed, a multicenter study was initiated, which was based on the very same methodological approach.…”

“…Pacemaker implantation has been described in detail previously [13]. Patient management, immunosuppressive therapy, and the threshold for rejection therapy were subject to individual center preference.…”

“…Twenty out of the 25 cases with significant rejection were correctly identified by VER T-slew values below a threshold of 98% (sensitivity = 80%, specificity = 50%, negative predictive Since 1992 we have developed a pacemaker-based system for the analysis of IEGMs to recognize acute cardiac allograft rejection. The current pacemaker system configuration and the parameters used to detect absence of rejection have been described in detail elsewhere [4,9,10,11,12,13,21,221. The present study was initiated to assess the suitability of CHARM for monitoring the absence of rejection in a blind, prospective, multicenter context.…”

Myeloperoxidase and carbonyl proteins: Promising markers for non-invasive monitoring of graft rejection after heart transplantation

“…Therefore, EMB use should be minimized and less invasive strategies should be pursued. 4 Several methods for monitoring rejection after HTx have been tested, including intramyocardial electrography, 5 echocardiography, 5 computerized heart acute rejection monitoring 6 (CHARM) and clinical-chemical laboratory/ serum parameters (e.g., endothelin 7 and neopterin 8 ), but have shown limited success, whereas pro-brain natriuretic peptide 9 (proBNP) and C-reactive protein 9,10 (CRP) are more promising. Furthermore, gene expression profiling of blood cells and proteomics is also under investigation for non-invasive rejection monitoring.…”