Reversible abnormality of electrocardiogram as a sign of acute cardiac rejection after orthotropic heart transplantation

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• 作者：Teruhiko Imamura ; MD^a ; Koichiro Kinugawa ; MD ; PhD ; FJCC^a ; ^{kinugawa-tky@umin.ac.jp} ; Taro Shiga ; MD ; PhD^a ; Miyoko Endo^b ; Toshiro Inaba ; MD^a ; Hisataka Maki ; MD^a ; Masaru Hatano ; MD^a ; Atsushi Yao ; MD ; PhD^a ; Yasunobu Hirata ; MD ; PhD^a ; Ryozo Nagai ; MD ; PhD ; FJCC^a
• 关键词：Cardiac rejection ; Heart transplantation ; Diastolic dysfunction ; Right axis deviation ; Electrocardiogram
• 刊名：Journal of Cardiology Cases
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：5
• 期：2
• 页码：e113-e117
• 全文大小：812 K

文摘

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Summary

Cardiac allograft rejection can be accompanied by diastolic dysfunction, but the hemodynamic change is usually compensated and hard to be recognized noninvasively. Here we report on two transplanted patients who showed electrocardiogram (ECG) changes suggesting right ventricular overload. Hemodynamic measurement revealed increased right ventricular pressure and endomyocardial biopsy confirmed grade 3R rejection. After rejection was treated with steroid pulse, the ECG alterations were reversed and right ventricular pressure was normalized. In such cases, asymptomatic rejection may be diagnosed by ECG changes that are reversible along with the treatment of rejection, although those ECG changes are apparently non-specific.