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Imamura T, Kinugawa K, Shiga T, et al. Reversible abnormality of electrocardiogram as a sign of acute cardiac rejection after orthotropic heart transplantation. J Cardiol Cases. 2012;5(2):e113-e117doi: 10.1016/j.jccase.2012.01.004.
Imamura, T., Kinugawa, K., Shiga, T., Endo, M., Inaba, T., Maki, H., Hatano, M., Yao, A., Hirata, Y., & Nagai, R. (2012). Reversible abnormality of electrocardiogram as a sign of acute cardiac rejection after orthotropic heart transplantation. Journal of cardiology cases, 5(2), e113-e117. https://doi.org/10.1016/j.jccase.2012.01.004
Imamura, Teruhiko, et al. "Reversible abnormality of electrocardiogram as a sign of acute cardiac rejection after orthotropic heart transplantation." Journal of cardiology cases vol. 5,2 (2012): e113-e117. doi: https://doi.org/10.1016/j.jccase.2012.01.004
Imamura T, Kinugawa K, Shiga T, Endo M, Inaba T, Maki H, Hatano M, Yao A, Hirata Y, Nagai R. Reversible abnormality of electrocardiogram as a sign of acute cardiac rejection after orthotropic heart transplantation. J Cardiol Cases. 2012 Feb 28;5(2):e113-e117. doi: 10.1016/j.jccase.2012.01.004. eCollection 2012 Apr. PMID: 30532917; PMCID: PMC6265495.
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J Cardiol Cases. 2012 Feb 28;5(2):e113-e117. doi: 10.1016/j.jccase.2012.01.004. eCollection 2012 Apr.

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

Journal of cardiology cases

Teruhiko Imamura, Koichiro Kinugawa, Taro Shiga, Miyoko Endo, Toshiro Inaba, Hisataka Maki, Masaru Hatano, Atsushi Yao, Yasunobu Hirata, Ryozo Nagai

Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Japan.
  2. Department of Organ Transplantation, Graduate School of Medicine, University of Tokyo, Japan.

PMID: 30532917 PMCID: PMC6265495 DOI: 10.1016/j.jccase.2012.01.004

Abstract

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.

Keywords: Cardiac rejection; Diastolic dysfunction; Electrocardiogram; Heart transplantation; Right axis deviation

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