Key result
Heart transplant recipients show ~3-fold higher periodic repolarization dynamics than controls, with similar deceleration capacity.
Why the study?
Autonomic reinnervation after heart transplantation remains incomplete, and its long-term electrophysiological consequences are poorly understood.
Does orthotopic heart transplantation alter periodic repolarization dynamics and deceleration capacity compared to age-matched controls two to five years post-transplant?
Observational (n=33)
Does orthotopic heart transplantation alter periodic repolarization dynamics and deceleration capacity compared to age-matched controls two to five years post-transplant?
Answers are grounded in this paper and cite their sources.
Heart transplant recipients exhibit significantly increased periodic repolarization dynamics years after transplant compared to age-matched controls while deceleration capacity remains comparable, suggesting enhanced sympathetic modulation of ventricular repolarization.
Introduction Periodic repolarization dynamics (PRD) is an ECG-based risk marker reflecting sympathetic-activity related modulation of ventricular repolarization. (1) Deceleration capacity of heart rate (DC) represents an integral measure of predominantly vagally mediated heart rate dynamics. (2) Following heart transplantation (HTx), autonomic reinnervation remains incomplete, yet its long-term electrophysiological consequences are poorly understood. Methods We included 19 stable patients two to five years after orthotopic heart transplantation who underwent standardized 30 min high resolution ECG recordings in Frank lead configuration. PRD and DC were quantified using established algorithms and compared with age-matched controls. Group comparisons were performed using Wilcoxon rank-sum tests and Fisher’s exact tests, as appropriate. Results HTx recipients had a mean age of 59.0 ± 9.6 years and 5 (26.3 %) were female compared with mean age of 61.5 ± 7.8 years in the control group (p = 0.802), of whom 8 (57.1 %) were females (p = 0.148). PRD was significantly higher in HTx recipients compared to controls (4.88 [IQR 6.86] vs 1.67 [IQR 2.03] deg²; p = 0.007). In contrast, DC did not differ significantly between groups (1.45 [IQR 0.85] vs 1.43 [ IQR 1.12] ms; p = 0.743). Conclusion PRD is significantly increased years after HTx, whereas DC remains comparable to age-matched controls. This dissociation suggests enhanced sympathetic modulation of ventricular repolarization, potentially reflecting heterogeneous sympathetic re-innervation without detectable changes in global heart rate deceleration dynamics. Future studies are needed to evaluate the prognostic implications of PRD after HTx.
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Knap et al. (2026) conducted an observational in Orthotopic heart transplantation (n=33). Orthotopic heart transplantation (2 to 5 years post-transplant) vs. Age-matched controls was evaluated on Periodic repolarization dynamics (PRD) in deg² (p=0.007). Heart transplant recipients 2-5 years post-HTx had higher periodic repolarization dynamics than controls (4.88 vs 1.67 deg²; p=0.007) with similar deceleration capacity (1.45 vs 1.43 ms; p=0.743).
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