Vegard Bruun Bratholm Wyller1,2, Sissel Nygaard3,4, Anders Haugom Christensen3,4, Katrine Rolid3,5, Kari Nytrøen3,5, Lars Gullestad3,5,6,7, Arnt Fiane8, Erik Thaulow4, Gaute Døhlen4, J Philip Saul9. 1. Department of Pediatrics, Akershus University Hospital, 1478, Lørenskog, Norway. v.b.b.wyller@medisin.uio.no. 2. Faculty of Medicine, University of Oslo, Oslo, Norway. v.b.b.wyller@medisin.uio.no. 3. Faculty of Medicine, University of Oslo, Oslo, Norway. 4. Department of Pediatric Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway. 5. Department of Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway. 6. KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway. 7. Center for Heart Failure Research, Oslo University Hospital, Oslo, Norway. 8. Department of Cardiothoracic Surgery, Rikshospitalet, Oslo University Hospital, Oslo, Norway. 9. Department of Pediatrics, West Virginia University, Morgantown, WV, USA.
Abstract
PURPOSE: Heart transplantation (HTx) implies denervation of afferent neural connections. Reinnervation of low-pressure cardiopulmonary baroreceptors might impact the development and treatment of hypertension, but little is known of its occurrence. The present prospective study investigated possible afferent reinnervation of low-pressure cardiopulmonary baroreceptors during the first year after heart transplantation. METHODS: A total of 50 heart transplant recipients (HTxRs) were included and were evaluated 7-12 weeks after transplant surgery, with follow-up 6 and 12 months later. In addition, a reference group of 50 healthy control subjects was examined once. Continuous, non-invasive recordings of cardiovascular variables were carried out at supine rest, during 15 min of 20° head-up tilt, during Valsalva maneuver and during 1 min of 30% maximal voluntary handgrip. In addition, routine clinical data including invasive measurements were used in the analyses. RESULTS: During the first year after HTx, the heart rate (HR) response to 20° head-up tilt partly normalized, a negative relationship between resting mean right atrial pressure and HR tilt response developed, low-frequency variability of the RR interval and systolic blood pressure at supine rest increased, and the total peripheral resistance response to Valsalva maneuver became stronger. CONCLUSION: Functional assessments suggest that afferent reinnervation of low-pressure cardiopulmonary receptors occurs during the first year after heart transplantation, partially restoring reflex-mediated responses to altered cardiac filling.
PURPOSE: Heart transplantation (HTx) implies denervation of afferent neural connections. Reinnervation of low-pressure cardiopulmonary baroreceptors might impact the development and treatment of hypertension, but little is known of its occurrence. The present prospective study investigated possible afferent reinnervation of low-pressure cardiopulmonary baroreceptors during the first year after heart transplantation. METHODS: A total of 50 heart transplant recipients (HTxRs) were included and were evaluated 7-12 weeks after transplant surgery, with follow-up 6 and 12 months later. In addition, a reference group of 50 healthy control subjects was examined once. Continuous, non-invasive recordings of cardiovascular variables were carried out at supine rest, during 15 min of 20° head-up tilt, during Valsalva maneuver and during 1 min of 30% maximal voluntary handgrip. In addition, routine clinical data including invasive measurements were used in the analyses. RESULTS: During the first year after HTx, the heart rate (HR) response to 20° head-up tilt partly normalized, a negative relationship between resting mean right atrial pressure and HR tilt response developed, low-frequency variability of the RR interval and systolic blood pressure at supine rest increased, and the total peripheral resistance response to Valsalva maneuver became stronger. CONCLUSION: Functional assessments suggest that afferent reinnervation of low-pressure cardiopulmonary receptors occurs during the first year after heart transplantation, partially restoring reflex-mediated responses to altered cardiac filling.
Authors: M Estorch; M Campreciós; A Flotats; C Marí; L Bernà; A M Catafau; M Ballester; J Narula; I Carrió Journal: J Nucl Med Date: 1999-06 Impact factor: 10.057
Authors: Anders H Christensen; Sissel Nygaard; Katrine Rolid; Kari Nytrøen; Lars Gullestad; Arnt Fiane; Erik Thaulow; Gaute Døhlen; J Philip Saul; Vegard B B Wyller Journal: Transplantation Date: 2020-12-14 Impact factor: 4.939