RESUMO
Endomyocardial biopsy remains the gold standard of diagnosis of acute cellular rejection after heart transplantation. However, routine biopsies are of major inconvenience to patients and are also risky and costly. In the present research we considered possibility of non-invasive diagnosis of acute cellular rejection in patients after orthotopic heart transplantation. Results of research are based on studying 34 endomyocardial biopsys in combination with Holter monitoring and ECHO findings in 21 heart recipients. It is demonstrated that case follow-up with Holter monitoring and ECHO is mandatory for diagnosis of acute cellular rejection and optimal treatment tactics.
Assuntos
Ecocardiografia , Eletrocardiografia Ambulatorial , Rejeição de Enxerto/diagnóstico , Rejeição de Enxerto/prevenção & controle , Transplante de Coração/efeitos adversos , Doença Aguda , Adulto , Biópsia , Ecocardiografia/métodos , Ecocardiografia/normas , Eletrocardiografia Ambulatorial/métodos , Eletrocardiografia Ambulatorial/normas , Endocárdio/patologia , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/fisiopatologia , Hemodinâmica , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Monitorização Imunológica , Miocárdio/patologiaRESUMO
Cardiac malformations as minor anomalies have anatomic features that influence intracardiac hemodynamics, and contribute to thrombogenesis in the cardiac chambers, sclerosis of the endocardial portions adjacent to an anomaly, and to the development of infective endocarditis. However, their life-time recognition involves difficulties due to the fact that physicians are unaware of the structure, topography, and impact of the malformations on pathogenesis and thanatogenesis. Studying the anatomy of rare cardiac minor anomalies occurring in 7.79% of cases promotes their better life-time diagnosis and the prevention of pathogenetically related complications.