Signs of vagal reinnervation 4 years after heart transplantation in spectra of heart rate variability

Eur J Cardiothorac Surg. 1997 Dec;12(6):907-12. doi: 10.1016/s1010-7940(97)00271-6.

Abstract

Several investigators have shown signs of possible sympathetic but not parasympathetic reinnervation in heart transplanted patients. Spectral analysis of heart rate and blood pressure variability is a noninvasive tool appropriate to detect a functional autonomous reinnervation to the heart. In a follow-up study, 13 patients after heart transplantation (HTx) were investigated, mean age 50.6+/-8.5 years, 18 healthy volunteers were selected as control group. For each patient two recordings were performed which took part 14+/-5 months respectively 42+/-8 months after HTx. ECG and systolic blood pressure (SBP) have been recorded simultaneously for 5 min in supine position during controlled respiratory rate of 12 or 15 cycles/min. No graft rejection has been detected in the endomyocardial biopsy performed right after the recordings. Power spectral densities (PSD) were calculated for the beat-to-beat time series of RR-intervals (distance of two following QRS complexes) and SBPs. The area of PSD in the range of 0.05-0.17 Hz was defined as low frequency (LF) and that of 0.18-0.35 Hz as high frequency (HF). LF and HF are indicative of efferent sympathetic respectively parasympathetic activity at the sinus node. A significant increase of LF (226%) and HF (213%) during a mean period of 28 months could be found. No differences were to be shown for systolic blood pressure variability. Previous findings confirm that LF band increases 4 years after transplantation, suggesting a possible sympathetic reinnervation of the heart. On the other hand an increase of the HF band also suggests a parasympathetic reinnervation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Baroreflex / physiology
  • Blood Pressure / physiology
  • Cardiomyopathies / surgery
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart / innervation*
  • Heart Rate / physiology*
  • Heart Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Nerve Regeneration
  • Vagus Nerve / physiology*