title: Registration of thoracic electrical bioimpedance for early diagnosis of rejection after heart transplantation.
abstract: In this study, registration of thoracic electrical bioimpedance was used for early detection of acute rejection after heart transplantation. Thirty-five heart transplant recipients were monitored by registration of thoracic electrical bioimpedance signals during the immediate postoperative period and during the outpatient follow-up. At the same time, endomyocardial biopsy specimens were taken. In addition to cardiac stroke volume index and ejection fraction, the acceleration index (seconds -2) was calculated. This acceleration index describes the acceleration of blood volume and represents a function parameter of the myocardial inotropy. Seventeen acute rejection episodes were diagnosed during the follow-up period. The average acceleration index value during the 17 rejection episodes was 92.5 +/- 11.7 sec-2 and thus significantly lower when compared with the nonrejection levels (p < 0.05). The acceleration index values decreased during acute rejections by an average of 36.4 +/- 19.3 sec-2 (28%). The sensitivity of this diagnostic parameter in the examined patients was 71%, and the specificity was 100%. Thus registration of thoracic electrical bioimpedance and calculation of the acceleration index represents a quick and noninvasive monitoring technique and can ideally be used in the outpatient clinic as a supplement to invasive endomyocardial biopsies.
authors.affiliation: Department of Cardiac Surgery, Klinikum Grosshadern, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Weinhold
authors.forename: H
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: P
authors.initials: P
authors.lastname: Fülle
authors.forename: G
authors.initials: G
authors.lastname: Nollert
authors.forename: B
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000328:Adult; D001706:Biopsy; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology; D002307:Cardiography, Impedance; D017097:Electric Impedance; D004699:Endocardium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis* / Q000473:pathology; D016027:Heart Transplantation / Q000009:adverse effects* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D013909:Thorax / Q000502:physiology