title: Reliability of intramyocardial electrogram for the noninvasive diagnosis of acute allograft rejection after heart transplantation in rats.
abstract: OBJECTIVE
  To examine the reliability of the QRS amplitude of the autonomous intramyocardial electrogram (IMEG) and the maximum slope of the descending T wave (Tslew) of the ventricular evoked response (VER) for surveillance of acute allograft rejection (AR) after heart transplantation in rats.
  
  
  METHODS
  Forty rats underwent heterotopic heart transplantation, including ten isograft (isograft group) and 30 allograft (allograft group) recipients. Autonomous IMEG and VER were recorded with epicardiac pacing leads. Isograft recipients were sacrificed on postoperative day 7 and allograft recipients on postoperative days 3, 5 and 7. Graft heart histopathological examinations were performed at the corresponding time points.
  
  
  RESULTS
  Postoperative QRS amplitude and Tslew gradually decreased in the allograft group, but were unaltered in the isograft group. Decreases in the allograft group QRS amplitudes and Tslew values correlated with the histopathological results. At the optimal cutoff point of 90%, Tslew had 94.74% sensitivity, 81.82% specificity, 82.61% positive and 90% negative predictive values. QRS had 68.42% sensitivity, 90.91% specificity, 92.86% positive and 62.50% negative predictive values at its optimal cutoff point of 72.3%.
  
  
  CONCLUSIONS
  The QRS amplitude of the autonomous IMEG and Tslew of VER are reliable markers for monitoring AR after heart transplantation in rats.
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Jiahai
authors.initials: J
authors.lastname: Shi
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Shiguo
authors.initials: S
authors.lastname: Qian
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Meng
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Han
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Yangtian
authors.initials: Y
authors.lastname: Chen
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Jiangang
authors.initials: J
authors.lastname: Wang
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 1 Department of Cardiothoracic Surgery, Affiliated Hospital of Nantong University, Nantong 226001, China ; 2 Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China ; 3 Department of Thoracic Surgery, People's hospital of Binhai County, Yancheng 224500, China.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Jia
keywords: Heart transplantation; acute allograft rejection; intramyocardial electrogram (IMEG)