Application Of Right Ventricular Functional Parameter In Detecting Allograft Rejection In Heart Transplants

Objectives:Using echocardiography to evaluate the right ventricular function in detecting allograft rejection in heart transplant patients, to provide a new way to diagnose the allograft rejection.Methods:Choose the heart transplant patients been operated from August 2000 to December 2009, checked by real-time three-dimensional echocardiography(RT3DE),28 patients in all, and were divided into rejection group (Group A) and non-rejection group(group B), then choose 25 healthy subjects. Then two-dimensional echocardiography and pulse wave Doppler were performed in the three groups. RT3DE "full volume" imaging was acquired in four chamber view, then right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume(RVESV) and right ventricle ejection fraction(RVEF) were calculated.Results:1. Left atria diameter in group A and B was enlarger than that of group C. Other left index all in right range.2. Tei index of Group A is higher than Group B and Group C.3. RVEF with RT3DE in group A was lower than those of group B and C. Right ventricular systolic function deteriorated in allograft rejection heart transplants compared with healthy subjects.4. The result of RVEF and Tei index have correlations.5. In all the patients without clinical symptom, whose RVEF under 30% have clinical symptom in 12 months. With the hoist of RVEF, clinical symptom reduced significantly in 12 months.Conclusions:1. Change of left ventricle in heart transplant patients can't reflect allograft rejection after the operation.2. Difference of Tei index between allograft rejection patients and non-rejection patients can help to diagnose the allograft rejection.3. RT3DE can help to diagnose the allograft rejection after heart transplant.4. In all the patients without clinical symptom, lower the RVEF is, higher the clinical symptom appear in future.