Why the study?
Does heart transplantation alter the circadian rhythm of blood pressure and heart rate in patients with severe heart failure?
Does heart transplantation alter the circadian rhythm of blood pressure and heart rate in patients with severe heart failure?
The circadian rhythm of blood pressure and heart rate is lost early after heart transplantation but recovers by one year, suggesting a reacquisition of neurovegetative chronoregulation.
May warrant timed BP/HR monitoring early after heart transplant; leaves open whether recovery reflects autonomic reinnervation.
The aim of this study was to investigate the natural history of the circadian rhythm of blood pressure (BP) and heart rate (HR) in 10 patients with heart failure (class IV of the New York Heart Association), who underwent heart transplantation because of primary congestive cardiomyopathy. The control group was 10 age-matched clinically healthy subjects. The BP and HR monitorings were performed before and after transplantation. Preoperatively, analysis of variance and cosinor methods validated the occurrence of a statistically significant BP and HR circadian rhythm in cardiopathic patients. Over the 4 days after surgery, both the cosinor method and serial section analysis were unable to validate a 24-h periodicity for BP and HR in patients with heart transplants. Six months after surgery, the BP and HR circadian rhythm was not detected as well. One year after transplantation, the BP and HR circadian rhythm was statistically validated. The recovery of the BP and HR circadian rhythm 1 year after heart transplantation can be regarded as a clinical sign of a reacquired susceptibility to neurovegetative chronoregulation.
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Cugini et al. (1993) studied this question.