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Lookup NU author(s): Dr Moloy Das, Dr Janet McComb, Emeritus Professor Alan MurrayORCiD, Dr Gareth Parry
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© 2024 International Society for the Heart and Lung Transplantation. Background: Partial cardiac sympathetic reinnervation after cardiac transplant has been extensively investigated and evidenced. However, there have been no large-scale, long-term studies evaluating the prevalence, time-course, and association with long-term survival of sympathetic reinnervation of the heart. Methods: Cardiac transplant recipients (n = 232) were recruited from outpatient clinic at a single transplant center in the United Kingdom. Participants were each tested once for the presence of sympathetic reinnervation of the sinus node using the low-frequency component of power spectral analysis of heart rate variability, with a cutoff defined as 2 standard deviations above the mean for denervated participants (those tested <56 days posttransplant). Time course was calculated based on the timing of testing posttransplant. Patients were then followed up over a period of up to 27 years after transplant for survival analysis. Results: The overall prevalence of cardiac sympathetic reinnervation in the 225 patients tested >56 days posttransplant was 64.9%. Sympathetic reinnervation primarily occurred in the first 18 months after transplant, with a plateau thereafter. The prevalence in participants tested >18 months posttransplant was 69.6%. In Kaplan-Meier survival analysis, sympathetic reinnervation was associated with significantly improved survival (Log-rank p = 0.019), with a median survival time for reinnervated patients of 19.9 years compared with 14.4 years for the denervated group. Conclusions: Sympathetic reinnervation of the sinus node occurs mostly within 18 months of transplant, is found in 70% of cardiac transplant recipients tested >18 months posttransplant, and is associated with significantly improved long-term survival.
Author(s): Weiner OJF, Das M, Clayton RH, McComb JM, Murray A, Parry G, Lord SW
Publication type: Article
Publication status: Published
Journal: Journal of Heart and Lung Transplantation
Year: 2024
Pages: Epub ahead of print
Online publication date: 18/10/2024
Acceptance date: 02/04/2018
ISSN (print): 1053-2498
ISSN (electronic): 1557-3117
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.healun.2024.10.009
DOI: 10.1016/j.healun.2024.10.009
PubMed id: 39427965
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