Does the measurement of left ventricular isovolumic relaxation time allow early prediction of cardiac allograft rejection?

• Published in: Acta cardiologica Vol. 47; no. 5; p. 459
• Main Authors: Forster, T, McGhie, J, Rijsterborgh, H, Meeter, K, Balk, A, Essed, C, Roelandt, J
• Format: Journal Article
• Language: English
• Published: England 1992
• Subjects: Adolescent; Adult; Biopsy; Diastole - physiology; Electrocardiography - instrumentation; Endocardium - pathology; Female; Graft Rejection - diagnostic imaging; Graft Rejection - physiopathology; Heart Transplantation - physiology; Humans; Male; Middle Aged; Myocardial Contraction - physiology; Myocardium - pathology; Postoperative Complications - diagnostic imaging; Postoperative Complications - physiopathology; Signal Processing, Computer-Assisted - instrumentation; Sinoatrial Node - physiopathology; Ultrasonography; Ventricular Function, Left - physiology
• ISSN: 0001-5385

In order to evaluate the value of isovolumic relaxation time measurement for the diagnosis of moderate acute rejection episodes in cardiac allograft recipients a comparison was made with the histological results from the endomyocardial biopsy. A total of 202 isovolumic relaxation time measurements from 26 patients were compared to the biopsy results. The technique used to record isovolumic relaxation time was dual M-mode echocardiography. In addition a combined phonoechocardiography was used for 54 isovolumic relaxation time measurements from 17 patients. A good correlation was found between these two methods. When the biopsy results were normal the isovolumic relaxation time was 71.4 +/- 15.1 ms. When moderate acute rejection episodes were present isovolumic relaxation time decreased to 50.2 +/- 21.2 ms (p < 0.001). In spite of the close correlation detected at group level, there was a large variability of the measurements without accompanying changes in the biopsy specimen. At the same time a significant overlap was found between the measurements taken during rejection and non-rejection periods making it impossible to use these methods for clinical decision making. We conclude that isovolumic relaxation time measured with these methods is not a sufficiently sensitive parameter for the diagnosis of moderate acute rejection episodes in the individual patient, and in our experience, it is not a substitute for endomyocardial biopsy and can not be applied for clinical decision making.