Key result
Post-transplant denervated heart responds to exercise primarily by increasing stroke volume with delayed heart rate rise.
Why the study?
Hemodynamic characteristics and responses of the denervated heart after cardiac transplantation were not fully understood.
Case Report (n=1)
This early case report demonstrates that the denervated transplanted heart can increase cardiac output during exercise primarily through increased stroke volume and delayed catecholamine-mediated heart rate increases.
Stroke volume predominates in denervated heart exercise response; leaves open relevance to contemporary transplant exercise protocols.
Hemodynamic observations were performed one and six months after cardiac transplantation in a 46-year-old man. Cardiac catheterization revealed normal pressures at rest and a slightly decreased cardiac index. Total cardiac denervation was documented by absence of reflex changes in heart rate during physiologic and pharmacologic stimuli. Intracardiac electrocardiography demonstrated both donor and recipient p waves, the former always controlling the heart rate. Observations during atrioventricular dissociation indicated that the transplanted heart has active atrial transport. The denervated heart responded to the stress of muscular exercise. Cardiac output increased predominantly by increasing stroke volume, although delayed increments in heart rate occurred. After complete beta-adrenergic blockade, the response of the heart rate to exercise was attenuated but not completely blocked. These findings suggest that whereas circulating catecholamines have an important role in cardiac acceleration durin...
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Shaver et al. (1970) conducted a case report in Cardiac transplantation (n=1). Cardiac transplantation was evaluated on Hemodynamic observations. In a 46-year-old man after cardiac transplantation, the denervated heart responded to exercise predominantly by increasing stroke volume, with delayed increments in heart rate.
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