Diagnostische Wertigkeit von EKG-Veränderungen bei akuten kardialen Abstoßungsreaktionen nach orthotoper Herztransplantation

Abstract

Provided that ECGs are performed regularly, measurements of QTc time and QTc dispersion can reliably be used to detect an acute rejection in the early phase after heart transplantation.

Electrocardiographic Correlates of Acute Allograft Rejection Among Heart Transplant Recipients

“…3 Study evidence suggests that acute allograft rejection causes delays in ventricular repolarization and thereby increases the duration of the cellular action potential, resulting in a longer QT interval on the electrocardiogram. 4,5 To our knowledge, no prospective study has investigated whether such increases in the QT interval could provide early detection of acute allograft rejection. The aim of this study was to investigate the potential benefit of electrocardiographic monitoring to predict acute allograft rejection.…”

Remote noninvasive allograft rejection monitoring for heart transplant recipients: study protocol for the novel evaluation with home electrocardiogram and remote transmission (NEW HEART) study

“…A standardized correction to account for the effect of HR will be applied (QT C ). An increase in the QT C interval from the previous day of at least 25 ms that persists for 3 consecutive days will be considered abnormal [10]. …”

“…Using the variable definitions in Table 2, a logistic regression analysis will be performed with the independent variable being presence/absence of the ECG criteria (ΔQT C ≥ +25 ms × 3 days [10]) and the dependent variable being presence/absence of acute allograft rejection. Odds ratios and confidence intervals will be reported as well as the universal proportions used to determine the value of new diagnostic criteria (sensitivity, specificity, positive/negative predictive value, and predictive accuracy, Table 3).…”

“…In addition, we will report the proportion of subjects who develop the ECG criterion (≥ +25 ms increase in QT interval from previous day lasting 3 consecutive days [10]) before, during, or after the stages of mild, moderate, and severe rejection.…”

Feasibility and compliance with daily home electrocardiogram monitoring of the QT interval in heart transplant recipients

“…6 In normal individuals, there are two major influences on the duration of the QT interval: heart rate and autonomic nervous system activity. There is an inverse relationship between heart rate and the QT interval.…”