Parasympathetic reinnervation accompanied by improved post-exercise heart rate recovery and quality of life in heart transplant recipients.
Although sympathetic reinnervation is accompanied by the improvement of exercise tolerability during the first years after heart transplantation (HTx), little is known about parasympathetic reinnervation and its clinical impact. We enrolled 21 recipients (40 ± 16 years, 71% male) who had received successive cardiopulmonary exercise testing at 6 months, and 1 and 2 years after HTx. Exercise parameters such as peak oxygen consumption or achieved maximum load remained unchanged, whereas recovery parameters including heart rate (HR) recovery during 2 minutes and the delay of peak HR, which are influenced by parasympathetic activity, improved significantly during post-HTx 2 years (P < 0.05 for both). HR variability was analysed at post-HTx 6 months in 18 recipients, and high frequency power, representing parasympathetic activity, was significantly associated with the 2 recovery parameters (P < 0.05 for all). We also assessed quality of life using the Minnesota Living with Heart Failure (HF) Questionnaire at post-HTx 6 months and 2 years in the same 18 recipients, and those with improved recovery parameters enjoyed a better HF-specific quality of life (P < 0.05 for both). In conclusion, parasympathetic reinnervation emerges along with improved post-exercise recovery ability of HR and quality of life during post-HTx 2 years.
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo.
Teruhiko
T
Imamura
Koichiro
K
Kinugawa
Ikuko
I
Okada
Naoko
N
Kato
Takeo
T
Fujino
Toshiro
T
Inaba
Hisataka
H
Maki
Masaru
M
Hatano
Osamu
O
Kinoshita
Kan
K
Nawata
Shunei
S
Kyo
Minoru
M
Ono
D000328:Adult; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000294:innervation*; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate / Q000502:physiology*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010275:Parasympathetic Nervous System / Q000503:physiopathology*; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult