# Subjects Author/Yr | Study Design | Major Findings | Study Limitations | Implications for NEW HEART Study |
---|---|---|---|---|
N = 65 Richartz et al. 1998 [8] | Prospective; Rejection during in-hospital period | 1. Mean QTC = 449 ± 2 ms without rejection; 517 ± 11 ms with rejection (p < 0.001) 2. > 10% increase in QTC predicted rejection with sensitivity, 86%; specificity, 88% | 1. Only observed rejection during hospitalization for transplant surgery 2. Analyzed only 3 ECGs per subject 3. ECG analyzers not blinded from clinical information about rejection | An increase in the QT interval predicts acute allograft rejection |
N = 52 Kolasa et al. 2005 [9] | Retrospective; Long-term mortality over 7 yrs | Poorer survival over 7 yrs in subjects who had a > 10 ms per year change in their QTC interval on their annual ECG | 1. Link to rejection not studied 2. Analyzed only one ECG per year | As little as a 10 ms change in the QT interval is linked to mortality |
N = 200 Tenderich et al. 2006 [10] | Retrospective; Rejection during first 3 months | > 25 ms increase in QTC interval predicted acute allograft rejection with sensitivity, 77%; specificity, 96%. | 1. Only analyzed 2 ECGs per subject 2. ECG analyzers not blinded from clinical information about rejection | Increase in QT interval predicts acute rejection during the period of interest |
N = 587 Vrtovec et al. 2006 [11] | Retrospective; Long-term mortality up to 17 yrs | 1. Patients with ≥ 10% increase in QTC interval between 1st and 2nd year post-transplant had 6.86 times higher risk of dying.2. ≥ 10% increase in QTC was the only independent predictor of long- term mortality on multivariate analysis 3. Trend was a decreasing QTC over the yrs suggesting sympathetic reinnervation | 1. Link to rejection not studied 2. Analyzed only one ECG per year | An increase in the QT interval is linked to mortality |
N = 71 Vrtovec et al. 2008 [12] | Retrospective; 1- year all-cause & SCD mortality in subjects with severe acute rejection | 1. QTC was longer in SCD group than in survivors (475 ± 57 versus 437 ± 36 ms; p = 0.02) 2. Patients who had > 10% increase in QT interval during a severe acute rejection episode were at increased risk for SCD. | 1. Limited to just patients with severe rejection; unable to tell whether increased QT interval could predict earlier, milder forms of rejection 2. Analyzed just 2 ECGs per subject (one at baseline 7 days after surgery, second at time of rejection) | An increase in the QT interval is linked to mortality |