Author/Editor     Samarin-Lovrič, Silvia
Title     Variabilnost elektrokardiograma po presaditvi srca
Type     monografija
Place     Ljubljana
Publisher     Univerza v Ljubljani, Medicinska fakulteta
Publication year     2005
Volume     str. 75
Language     slo
Abstract     Objective: During the heart transplantation procedure, allograft becomes completely denervated. Partial ventricular sympathetic reinnervation may develop one year or later after the transplantation and is of functional significance. The relation between sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation is not known. Aim of our study was to assess sympathetic reinnervation of sinus node and left ventricle and to evaluate their time dependence. Methods: Two independent non-invasive methods were used: sympathetic reinnervation was evaluated with RR interval variability analysis and left ventricular sympathetic reinnervation was evaluated with iodine-123-meta-iodobenziylguanidine (123-IMIBG) scintigraphy. Twelve patients and 14 healthy controls were studied. Bipolar ECG with high sampling rate and resolution was recorded over 8.5 minutes in supine and in upright position. RR intervals in time domain and in frequency domain were analysed to evaluate sinus node reinnervation. Spectral power in low frequency (LF) range (0.04-O.15Hz) above 4.5 ms2 was considered as sinus node sympathetic reinnervation. Patients were divided in groups with sinus node sympathetic reinnervation (LF>4.5 ms2) and without sinus node sympathetic reinnervation (LF<4.5 ms2). In patients, 123-I-MIBG scintigraphy was performed. Heart to mediastinum ratio (HMR) was calculated and patients were divided in groups with left ventricular reinnervation (HMR>1.3) and without left ventricular reinnervation (HMR<1.3). The results of both methods were compared and the coexistence of sinus node sympathetic reinnervation and left ventricular sympathetic reinnervation was evaluated. Blood sample for plasma catecholamine levels was taken in supine body position in patients, just before 123-I-MIBG injection. (Abstract truncated at 2000 characters)
Descriptors     HEART TRANSPLANTATION
ELECTROCARDIOGRAPHY
SINOATRIAL NODE
SYMPATHETIC NERVOUS SYSTEM
HEART
HEART VENTRICLE
CATECHOLAMINES
SUPINE POSITION
HEART RATE