Open AccessHeart rate variability in patients with orthotopic heart transplantation: Long‐term follow‐up
Author(s) -
Folino Antonio Franco,
Buja Gianfranco,
Miorelli Manuela,
Livi Ugolino,
Nava Andrea,
Thiene Gaetano,
Dalla Volta Sergio
Publication year - 1993
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960160705
Subject(s) - medicine , reinnervation , heart transplantation , heart rate variability , transplantation , cardiology , heart rate , sinus rhythm , reflex , surgery , blood pressure , atrial fibrillation
To evaluate heart rate variability (expressed as the standard deviation of RR intervals) within 5 years of follow‐up, we studied 20 patients (14 males, 6 females, mean age 44 ± 12 years) who underwent orthotopic heart transplantation. Six measurements were taken: one in the first 3 weeks after transplantation, and the others once annually, for 5 years. Twenty healthy subjects (mean age 44 ± 7 years) constituted the control group. Heart rate variability increased significantly in the first 3 years of follow‐up (7.2 ± 1 vs. 11.1 ± 4, p < 0.001; 11.1 ±4vs. 15.2±4, p<0.01; 15.2±4vs. 18.9±5, p< 0.05); in the following years this trend slackened and values did not reach a statistically significant difference (18.9 ± 5 vs. 21.4 ± 5; 21.4 ± 5 vs. 22.5 ± 5). The mean standard deviation was invariably greater in the control group (63.6 ± 12). These findings show that sinus rhythm variability in the denervated heart progressively increased over 5 years of follow‐up. The absence of presynaptic uptake, which is responsible for adrenergic hypersensitivity to circulating catecholamines and intrinsic cardiac reflexes, does not appear to cause this phenomenon, since these mechanisms are not able to evolve in time after cardiac transplantation. Therefore, an enhanced beta‐adrenergic receptors density or affinity to circulating catecholamines or a limited sympathetic reinnervation may be the more probable underlying mechanism.