Mannaerts H F, Balk A H, Simoons M L, Tijssen J, van der Borden S G, Zondervan P, Sutherland G R, Roelandt J R
Department of Cardiology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Br Heart J. 1992 Oct;68(4):356-64. doi: 10.1136/hrt.68.10.356.
Assessment of changes in left ventricular diastolic function and wall thickness after heart transplantation to verify whether these changes predicted acute rejection assessed by endomyocardial biopsy.
Follow up according to a predefined protocol of consecutive patients from the first week after transplantation.
Heart transplantation unit of the Thoraxcentre, University Hospital Rotterdam Dijkzigt, The Netherlands.
All 32 patients undergoing orthotopic heart transplantation from 1 January 1989 to 31 March 1990 were examined. Two were excluded from the analysis. Patients were treated with cyclosporin and low dose steroids.
Data obtained by digitised M mode echocardiography were compared with the results of endomyocardial biopsy (Billingham classification). Mean values for left ventricular wall thickness, internal dimension, and their standardised rates of change and fractional shortening were determined from 4-6 consecutive expiratory beats. Mean values and individual trends during follow up were also investigated for each ultrasound variable. The results of these average values were compared with values in a group of 10 healthy volunteers.
Median follow-up was 177 days (range 10-399). Two hundred and sixty three consecutive M mode studies were examined in relation to concurrent biopsy results. No significant differences were observed between the ultrasound variables at the time of moderate acute rejection (Billingham class 2, n = 37) and other biopsy classes (n = 226). Nor did changes in individual patients predict (moderate) acute rejection episodes. Twenty six of the 30 patients had an abnormal (slow) left ventricular relaxation pattern throughout follow up.
Digitised left ventricular M mode echocardiography did not predict the presence of acute rejection. In most patients there was a persistent slow left ventricular relaxation pattern.
评估心脏移植后左心室舒张功能和室壁厚度的变化，以验证这些变化是否能预测通过心内膜心肌活检评估的急性排斥反应。
按照预定方案对移植后第一周起的连续患者进行随访。
荷兰鹿特丹迪克斯希特大学医院胸科中心心脏移植科。
对1989年1月1日至1990年3月31日期间接受原位心脏移植的所有32例患者进行检查。2例被排除在分析之外。患者接受环孢素和低剂量类固醇治疗。
将数字化M型超声心动图获得的数据与心内膜心肌活检结果（比林厄姆分类）进行比较。从4 - 6个连续的呼气搏动中确定左心室壁厚度、内径及其标准化变化率和缩短分数的平均值。还对每个超声变量随访期间的平均值和个体趋势进行了研究。将这些平均值的结果与一组10名健康志愿者的值进行比较。
中位随访时间为177天（范围10 - 399天）。对263次连续的M型研究与同期活检结果进行了检查。在中度急性排斥反应时（比林厄姆2级，n = 37）和其他活检分级时（n = 226），超声变量之间未观察到显著差异。个体患者的变化也不能预测（中度）急性排斥反应发作。30例患者中有26例在整个随访期间左心室舒张模式异常（减慢）。
数字化左心室M型超声心动图不能预测急性排斥反应的存在。大多数患者存在持续的左心室舒张缓慢模式。
