Evidence of time-dependent autonomic reinnervation after heart transplantation.
BACKGROUND
Confirming the clinical significance of reinnervation is important in understanding and anticipating how heart rate (HR) responses of transplant recipients to physiologic stress differs early and late after transplant from that of normal individuals.


OBJECTIVE
To evaluate the functional significance of cardiac reinnervation early and late after heart transplantation.


METHODS
Handgrip and deep breathing tests, passive 80 degrees head-up tilt, and heart rate (HR) responsiveness of 33 transplant recipients (n = 16 at < 5 months and n = 17 at > 1 year after transplant) were compared with those of 16 age- and sex-matched control participants.


RESULTS
HR responses to handgrip and passive tilt were absent early after transplant. HR acceleration normalized but was blunted late after transplant. These findings are consistent with late (>1 year) sympathetic reinnervation in transplant recipients.


CONCLUSIONS
When caring for transplant recipients, nurses should consider the time elapsed since transplant in evaluating HR responsiveness to common procedures and interventions.
Doering
L V
LV
UCLA School of Nursing, Los Angeles, CA 90095-6918, USA.
Dracup
K
K
Moser
D K
DK
Czer
L S
LS
Peter
C T
CT
D000704:Analysis of Variance; D004562:Electrocardiography; D005260:Female; D018737:Hand Strength; D006321:Heart / Q000294:innervation*; D006339:Heart Rate; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010275:Parasympathetic Nervous System / Q000502:physiology; D011184:Postoperative Period; D013564:Sympathetic Nervous System / Q000502:physiology; D018667:Tilt-Table Test