Echo rejection score: new echocardiographic approach to diagnosis of heart transplant rejection

摘要: Objective: The gold standard test in the diagnosis of heart transplant rejection is right ventricular (RV) myocardial biopsy, which an invasive, time-consuming, expensive method. In effort to find a reliable method minimise sequential use we assessed main echocardiographic indices for detection allograft rejection. Materials and methods: Fifty specimens were examined this prospective study, prominent parameters propounded by previous studies as indicators Prior all patients underwent preoperative transthoracic echocardiography. accuracy was compared with that biopsy standard. At three segments, namely, RV base, interventricular septal (Sep) base lateral left (Lat) peak systolic strain (RV-S, Lat-S Sep-S) measured. addition, time systole (TS) measured at same yielding variables RV-TS, Sep-TS Lat-TS. Results: Our logistic regression model revealed four factors (%), (ms), posterior wall thickness (PWT; mm) mass index (LVMI; g m � 2 ) could denote hearttransplantrejection.Wedeviseda newindex,theechorejectionscore,usingthefollowingformula: [(PWT + LVMI) (Lat-S Sep-TS)].This new formula has area under curve 0.932 cut-off point 0; it yields sensitivity 100.0%, specificity 71.0%, positive predictive value 67.9% negative 100.0%. If echo score >0, there possibility cardiac patient presenting rejection, while 0 denotes 100% improbability Conclusion: proposed screening risk acute showed good graft However, further study required determine if can be used adjunct biopsy. # 2010 European Association Cardio-Thoracic Surgery. Published Elsevier B.V. All rights reserved.