Reliability of using tslew of intramyocardial electrogram to diagnose acute rejection after heart transplantation in rats
10.3760/cma.j.issn.1001-4497.2011.01.013
- VernacularTitle:心肌内心电图Tslew诊断大鼠急性排斥反应的可靠性
- Author:
Jiahai SHI
;
Xu MENG
;
Jie HAN
;
Haibo ZHANG
;
Yangtian CHEN
;
Yixin JIA
- Publication Type:Journal Article
- Keywords:
Heart transplantation;
Graft rejection;
Electrocardiography
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2011;27(1):35-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aimed to evaluate the reliability of Tslew in survelliance of allograft rejection after heart transplantations in rats. Methods Forty rats underwent modified Ono's heterotopic heart transplantation. The autonomous IMEG and VER were recorded with epicardiac pacing leads fixed at right ventricular outflow tracts, left ventricular apex and free wall. Tslews were detected daily in these 10 syngeneic and 30 allogeneic transplants. Syngeneic transplants were sacrificed on 7th postoperative day and allogeneic transplants were sacrificed on 3rd, 5th and 7th postoperative days, respectively.Histopathologic studies were performed at the same time. Results On the 3rd ,5th and 7th postoperative days Tslews depressed gradually in the allogeneic group. The depressions between 3rd and 5th, 3rd and 7th were obvious( P ＜0.05 ). No significant differences were observed in the syngeneic group. Tslews differed between the two groups at 5th and 7th postoperative days ( P ＜0.05 ). The Depression correlated with histopathologic results. Area under ROC( receiver operating characteristic) curve (AUC) of Tslew was 0.9474 and the 95% confidence interval(CI) was (0. 8753 -1. 0000 ). At the cutoff point of 92% ( ≤92% considered positive), Tslew had a sensitivity (Se) 100%, specificity (Sp) 63.64%, positive predictive value (PV + )82.61%, negative predictive value (PV-) 100%, respectively. At the cutoff point 85%, Sp 90.91%, Se 78.95%, PV +93.75 %, PV- 71. 43%. At the best cutoff point 90%, Tslew had a Se 94.74%, Sp 81. 82%, PV + 82.61%, PV- 90%.Whereas QRS had a Se 68.42%, Sp 90.91%, PV + 92.86%, PV- 62.50% at the best cutoff point of 72.3%. Conclusion Tslew of VER are reliable indexs to monitor acute allograft rejection after heart transplantations in rats. Having great diagnostic value, Tslew may be used as a replacement for EMB at the best cutoff point when EMB can' t be performed. At cutoff point of 92%, Tslew may be used as a screening index.
