title: Occurrence of neuropathies in patients with severe heart failure before and after heart transplantation.
abstract: Neuropathies may affect heart reinnervation and functional outcome after heart transplantation (HT). In this study, neurological evaluations, standard nerve conduction studies, and electromyography were performed in 32 HT candidates without a previous history of neuromuscular disorder. Ten patients underwent HT and were revaluated 3 months later. We found that before HT 10 (31.3%) patients had sensorimotor polyneuropathy (18.8%) or sensory polyneuropathy (12.5%). After HT, the percentage of patients with a neuromuscular disorder increased to 70%, most of them showing new or worsening neuropathies or neuromyopathies. The most sensitive abnormality that indicated neuromuscular involvement after HT was a reduction of the compound muscle action potential (CMAP) of the deep peroneal nerve. In conclusion, neuromuscular disorders are common in HT candidates, and they further increase in occurrence after HT. A reduction of the deep peroneal nerve CMAP amplitude after HT may help to identify patients who need a more detailed neurophysiological evaluation. The diagnosis of neuromuscular disorders before and after HT may contribute to the development of more accurate therapeutic and rehabilitative strategies for these patients.
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy. sergiobagnato@gmail.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bagnato
authors.affiliation: Heart Failure Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Minà
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Sant'Angelo
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Boccagni
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Prestandrea
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Caronia
authors.affiliation: Heart Failure Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Clemenza
authors.affiliation: Unit of Neurophysiology and Rehabilitation Department, San Raffaele G. Giglio Foundation Institute, Cefalù, PA, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Galardi
mesh_terms: D000328:Adult; D000368:Aged; D004576:Electromyography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D010543:Peroneal Nerve / Q000503:physiopathology; D020127:Recovery of Function; D013497:Sural Nerve / Q000503:physiopathology; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000503:physiopathology
keywords: EMG; Heart transplant candidates; Heart transplant recipients; Nerve conduction studies; Neuromuscular disorders