Kriehuber E A
Wien Med Wochenschr. 1987 Jan 15;137(1):27-9.
Applying immunosuppressive therapy with Ciclosporin A, the myocardium shows only little or no oedema in the cardiac rejection process. Thus the usefulness of electrocardiographic diagnosis using QRS-amplitudes of the surface electrocardiogram (unipolar precordial chest leads) for the early recognition of the (acute) cardiac rejection process, is considerably limited if not questionable when compared with the pre-ciclosporin period (63 cases with heart transplants). In a heart-lung transplant for instance a massive accumulation of fluid in the lungs (erroneously) can influence the QRS-amplitudes. In addition, the cardiac rejection index (KRI) obtained by unipolar chest leads and other electrocardiographic alterations should be watched continuously. With a high degree of reliance, the intra-myocardial electrogram (IMEG) permits a better diagnosis of the acute cardiac rejection process. For the early clinical diagnosis the use of additional noninvasive methods of examinations is advisable.
应用环孢素A进行免疫抑制治疗时，在心脏排斥反应过程中，心肌仅表现出轻微水肿或无水肿。因此，与使用环孢素前的时期（63例心脏移植患者）相比，利用体表心电图（单极胸前导联）的QRS波幅进行心电图诊断以早期识别（急性）心脏排斥反应过程的实用性，即使不说有问题，也是相当有限的。例如，在心肺移植中，肺部大量积液（错误地）会影响QRS波幅。此外，应持续观察通过单极胸前导联获得的心脏排斥指数（KRI）及其他心电图改变。心肌内心电图（IMEG）能更可靠地对急性心脏排斥反应过程进行诊断。对于早期临床诊断，建议使用其他非侵入性检查方法。
