title: Prediction of acute cardiac rejection by changes in left ventricular volumes.
abstract: Sixteen patients underwent heart transplantation (11 orthotopic, five heterotopic). Monitoring for acute rejection was by both endomyocardial biopsy (EMB) and multigated equilibrium blood pool scanning with technetium 99m-labelled red blood cells. From the scans information was obtained on left ventricular volumes (stroke, end-diastolic, and end-systolic), ejection fraction, and heart rate. Studies (208) were made in the 16 patients. There was a highly significant correlation between the reduction in stroke volume and end-diastolic volume (and a less significant correlation in end-systolic volume) and increasing acute rejection seen on EMB. Heart rate and ejection fraction did not correlate with the development of acute rejection. Correlation of a combination of changes in stroke volume and end-diastolic volume with EMB showed a sensitivity of 85% and a specificity of 96%. Radionuclide scanning is therefore a useful noninvasive tool for monitoring acute rejection.
authors.affiliation: Department of Cardiothoracic Surgery, Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Novitzky
authors.forename: D K
authors.initials: DK
authors.lastname: Cooper
authors.forename: J
authors.initials: J
authors.lastname: Boniaszczuk
mesh_terms: D001706:Biopsy; D006084:Graft Rejection; D006321:Heart / Q000000981:diagnostic imaging; D016027:Heart Transplantation; D006801:Humans; D009206:Myocardium / Q000473:pathology; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013667:Technetium
chemical_list: D013667:Technetium