Reversible Loss of Pre-excitation as a Sign of Acute Cardiac Rejection
A 50-year-old woman presented with signs of mild heart failure 16 months after orthotopic heart transplantation. Cardiac biopsy revealed ISHLT Grade 2R rejection, which was treated with corticosteroids. Electrocardiograms (ECGs) after transplantation showed a pre-excitation pattern; the presenting E...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2009-06, Vol.28 (6), p.647-650 |
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| container_end_page | 650 |
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| container_issue | 6 |
| container_start_page | 647 |
| container_title | The Journal of heart and lung transplantation |
| container_volume | 28 |
| creator | Jones, David G., MBBS, MRCP Bougard, Robert S., BSc Burke, Margaret M., MBBCh, FRCPath Banner, Nicholas R., BM, FRCP |
| description | A 50-year-old woman presented with signs of mild heart failure 16 months after orthotopic heart transplantation. Cardiac biopsy revealed ISHLT Grade 2R rejection, which was treated with corticosteroids. Electrocardiograms (ECGs) after transplantation showed a pre-excitation pattern; the presenting ECG showed complete loss of pre-excitation, which returned fully within 7 days of steroid therapy. Intermittent pre-excitation had been present for 4 weeks prior to any other clinical sign of rejection. Accessory pathways can display reversible loss of function during acute cellular rejection, and this may precede other clinical signs. This rare but significant finding may have clinical relevance to other transplanted patients with pre-excitation. |
| doi_str_mv | 10.1016/j.healun.2009.03.004 |
| format | Article |
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Cardiac biopsy revealed ISHLT Grade 2R rejection, which was treated with corticosteroids. Electrocardiograms (ECGs) after transplantation showed a pre-excitation pattern; the presenting ECG showed complete loss of pre-excitation, which returned fully within 7 days of steroid therapy. Intermittent pre-excitation had been present for 4 weeks prior to any other clinical sign of rejection. Accessory pathways can display reversible loss of function during acute cellular rejection, and this may precede other clinical signs. This rare but significant finding may have clinical relevance to other transplanted patients with pre-excitation.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2009.03.004</identifier><identifier>PMID: 19481028</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; Biological and medical sciences ; Biopsy ; Cardiology. Vascular system ; Electrocardiography ; Female ; Graft Rejection - diagnosis ; Graft Rejection - drug therapy ; Graft Rejection - physiopathology ; Heart Failure - diagnosis ; Heart Failure - drug therapy ; Heart Failure - physiopathology ; Heart Transplantation ; Humans ; Medical sciences ; Middle Aged ; Myocardium - pathology ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The Journal of heart and lung transplantation, 2009-06, Vol.28 (6), p.647-650</ispartof><rights>International Society for Heart and Lung Transplantation</rights><rights>2009 International Society for Heart and Lung Transplantation</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-c6a3cc5cddacf1e792940b60618dafd43560387a45e0a3bdf7e34a8529c5486e3</citedby><cites>FETCH-LOGICAL-c445t-c6a3cc5cddacf1e792940b60618dafd43560387a45e0a3bdf7e34a8529c5486e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healun.2009.03.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21588781$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19481028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jones, David G., MBBS, MRCP</creatorcontrib><creatorcontrib>Bougard, Robert S., BSc</creatorcontrib><creatorcontrib>Burke, Margaret M., MBBCh, FRCPath</creatorcontrib><creatorcontrib>Banner, Nicholas R., BM, FRCP</creatorcontrib><title>Reversible Loss of Pre-excitation as a Sign of Acute Cardiac Rejection</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>A 50-year-old woman presented with signs of mild heart failure 16 months after orthotopic heart transplantation. Cardiac biopsy revealed ISHLT Grade 2R rejection, which was treated with corticosteroids. Electrocardiograms (ECGs) after transplantation showed a pre-excitation pattern; the presenting ECG showed complete loss of pre-excitation, which returned fully within 7 days of steroid therapy. Intermittent pre-excitation had been present for 4 weeks prior to any other clinical sign of rejection. Accessory pathways can display reversible loss of function during acute cellular rejection, and this may precede other clinical signs. This rare but significant finding may have clinical relevance to other transplanted patients with pre-excitation.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Cardiology. Vascular system</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Graft Rejection - diagnosis</subject><subject>Graft Rejection - drug therapy</subject><subject>Graft Rejection - physiopathology</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardium - pathology</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV2L1TAQhoMo7of-A5He6F3r5LPpjbAcdl3hgLKr4F3ImU41taddk3Zx_72p56DgjVcZyDPvJM8w9oJDxYGbN331jfywjJUAaCqQFYB6xE651nUpOa8f5xq0LIVq7Ak7S6kHACG1eMpOeKMsB2FP2dUN3VNMYTdQsZ1SKqau-BippJ8YZj-HaSx8KnxxG76O690FLjMVGx_b4LG4oZ5whZ6xJ50fEj0_nufs89Xlp811uf3w7v3mYluiUnou0XiJqLFtPXac6kY0CnYGDLet71oltQFpa680gZe7tqtJKm-1aFAra0ies9eH3Ls4_VgozW4fEtIw-JGmJTlTS24MqAyqA4gx_ypS5-5i2Pv44Di41Z_r3cGfW_05kA5-t7085i-7PbV_m47CMvDqCPiEfuiiHzGkP5zg2tra8sy9PXCUbdwHii5hoBGpDTErc-0U_veSfwNwCGPIM7_TA6V-WuKYTTvuknDgbtddr6uGBoBr_kX-ApKyo8c</recordid><startdate>20090601</startdate><enddate>20090601</enddate><creator>Jones, David G., MBBS, MRCP</creator><creator>Bougard, Robert S., BSc</creator><creator>Burke, Margaret M., MBBCh, FRCPath</creator><creator>Banner, Nicholas R., BM, FRCP</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090601</creationdate><title>Reversible Loss of Pre-excitation as a Sign of Acute Cardiac Rejection</title><author>Jones, David G., MBBS, MRCP ; Bougard, Robert S., BSc ; Burke, Margaret M., MBBCh, FRCPath ; Banner, Nicholas R., BM, FRCP</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-c6a3cc5cddacf1e792940b60618dafd43560387a45e0a3bdf7e34a8529c5486e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Cardiology. Vascular system</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Graft Rejection - diagnosis</topic><topic>Graft Rejection - drug therapy</topic><topic>Graft Rejection - physiopathology</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardium - pathology</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jones, David G., MBBS, MRCP</creatorcontrib><creatorcontrib>Bougard, Robert S., BSc</creatorcontrib><creatorcontrib>Burke, Margaret M., MBBCh, FRCPath</creatorcontrib><creatorcontrib>Banner, Nicholas R., BM, FRCP</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jones, David G., MBBS, MRCP</au><au>Bougard, Robert S., BSc</au><au>Burke, Margaret M., MBBCh, FRCPath</au><au>Banner, Nicholas R., BM, FRCP</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reversible Loss of Pre-excitation as a Sign of Acute Cardiac Rejection</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2009-06-01</date><risdate>2009</risdate><volume>28</volume><issue>6</issue><spage>647</spage><epage>650</epage><pages>647-650</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>A 50-year-old woman presented with signs of mild heart failure 16 months after orthotopic heart transplantation. Cardiac biopsy revealed ISHLT Grade 2R rejection, which was treated with corticosteroids. Electrocardiograms (ECGs) after transplantation showed a pre-excitation pattern; the presenting ECG showed complete loss of pre-excitation, which returned fully within 7 days of steroid therapy. Intermittent pre-excitation had been present for 4 weeks prior to any other clinical sign of rejection. Accessory pathways can display reversible loss of function during acute cellular rejection, and this may precede other clinical signs. This rare but significant finding may have clinical relevance to other transplanted patients with pre-excitation.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19481028</pmid><doi>10.1016/j.healun.2009.03.004</doi><tpages>4</tpages></addata></record> |
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| ispartof | The Journal of heart and lung transplantation, 2009-06, Vol.28 (6), p.647-650 |
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| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adrenal Cortex Hormones - therapeutic use Biological and medical sciences Biopsy Cardiology. Vascular system Electrocardiography Female Graft Rejection - diagnosis Graft Rejection - drug therapy Graft Rejection - physiopathology Heart Failure - diagnosis Heart Failure - drug therapy Heart Failure - physiopathology Heart Transplantation Humans Medical sciences Middle Aged Myocardium - pathology Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Reversible Loss of Pre-excitation as a Sign of Acute Cardiac Rejection |
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