Document Detail

Sympathetic reinnervation after heart transplantation, assessed by iodine-123 metaiodobenzylguanidine imaging, and heart rate variability.
MedLine Citation:
PMID:  15450565     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Complete allograft denervation occurs during heart transplantation. Partial ventricular sympathetic reinnervation may develop one year or later after transplantation and can be measured with iodine-123-meta-iodobenziylguanidine (MIBG) uptake. Aim of this study was to assess sinus node sympathetic reinnervation measured with heart rate variability and ventricular sympathetic reinnervation evaluated with MIBG. METHODS: Twelve patients and 14 healthy controls were included. In patients, MIBG scintigraphy with early and late imaging was performed. Heart to mediastinum ratio (HMR) was calculated and patients were divided in groups with (HMR>1.3) and without left ventricular reinnervation (HMR<1.3). Bipolar ECG with high sampling rate and resolution was recorded over 8.5 min in supine position and in upright position after 10 min interval. R-R intervals in time domain and heart rate variability in frequency domain through spectral power analysis of R-R intervals were analysed to evaluate sinus node reinnervation. Spectral power in low frequency range (0.04-0.15 Hz) above 4.5 ms(2) was considered as sinus node sympathetic reinnervation. RESULTS: Six (50%) patients had evidence of left ventricular sympathetic reinnervation on scintigraphy. Sinus node sympathetic reinnervation based on heart rate variability was detected in 6 (50%) patients in supine, and in 4 (33%) patients in upright body position. Four patients groups were discerned: (1) with ventricular and sinus node sympathetic reinnervation, (2) with sinus node sympathetic reinnervation, (3) with ventricular sympathetic reinnervation and (4) without atrial or ventricular sympathetic reinnervation. Ventricular reinnervation process was time dependent and sinus node reinnervation was not. CONCLUSIONS: Simultaneous ventricular sympathetic reinnervation assessed by MIBG and sinus node sympathetic reinnervation assessed by heart rate variability in supine as in upright position were detected only in two patients (17%). The results of our study show that eventual sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation do not occur simultaneously.
Silvia Samarin Lovric; Viktor Avbelj; Roman Trobec; Darko Zorman; Peter Rakovec; Sergej Hojker; Borut Gersak; Metka Milcinski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  26     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-28     Completed Date:  2004-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  736-41     Citation Subset:  IM    
Department of Cardiology, University Medical Centre, Zaloska 7, Ljubljana, SI 1000, Slovenia.
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MeSH Terms
3-Iodobenzylguanidine / diagnostic use
Heart Rate
Heart Transplantation*
Heart Ventricles / innervation,  radionuclide imaging
Iodine Radioisotopes / diagnostic use
Middle Aged
Nerve Regeneration*
Postoperative Period
Posture / physiology
Sinoatrial Node / innervation*,  physiology
Sympathetic Nervous System / anatomy & histology,  physiology*
Reg. No./Substance:
0/Iodine Radioisotopes; 77679-27-7/3-Iodobenzylguanidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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