title: Signs of vagal reinnervation 4 years after heart transplantation in spectra of heart rate variability.
abstract: Several investigators have shown signs of possible sympathetic but not parasympathetic reinnervation in heart transplanted patients. Spectral analysis of heart rate and blood pressure variability is a noninvasive tool appropriate to detect a functional autonomous reinnervation to the heart. In a follow-up study, 13 patients after heart transplantation (HTx) were investigated, mean age 50.6+/-8.5 years, 18 healthy volunteers were selected as control group. For each patient two recordings were performed which took part 14+/-5 months respectively 42+/-8 months after HTx. ECG and systolic blood pressure (SBP) have been recorded simultaneously for 5 min in supine position during controlled respiratory rate of 12 or 15 cycles/min. No graft rejection has been detected in the endomyocardial biopsy performed right after the recordings. Power spectral densities (PSD) were calculated for the beat-to-beat time series of RR-intervals (distance of two following QRS complexes) and SBPs. The area of PSD in the range of 0.05-0.17 Hz was defined as low frequency (LF) and that of 0.18-0.35 Hz as high frequency (HF). LF and HF are indicative of efferent sympathetic respectively parasympathetic activity at the sinus node. A significant increase of LF (226%) and HF (213%) during a mean period of 28 months could be found. No differences were to be shown for systolic blood pressure variability. Previous findings confirm that LF band increases 4 years after transplantation, suggesting a possible sympathetic reinnervation of the heart. On the other hand an increase of the HF band also suggests a parasympathetic reinnervation.
authors.affiliation: Department of Cardiac Surgery, University of Munich, Klinikum Grosshadern, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Uberfuhr
authors.forename: A W
authors.initials: AW
authors.lastname: Frey
authors.forename: A
authors.initials: A
authors.lastname: Fuchs
authors.forename: C
authors.initials: C
authors.lastname: Paniara
authors.forename: H
authors.initials: H
authors.lastname: Roskamm
authors.forename: M
authors.initials: M
authors.lastname: Schwaiger
authors.forename: B
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000293:Adolescent; D017704:Baroreflex / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D009202:Cardiomyopathies / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000294:innervation*; D006339:Heart Rate / Q000502:physiology*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration; D014630:Vagus Nerve / Q000502:physiology*