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P5.9 Lack of Recovery in Nocturnal Decline of Heart Rate and Blood Pressure After Heart Trasplantation



The cardiac transplant (CTr) patient provides a unique model for the study of blood pressure(BP) and heart rate (HR) changing. The parasympathetic and sympathetic influeces ordinarily regulate circadian rhythm. This lack is known as denervation and these nerves rarely grow back. The aim of our study is to investigate the circadian rhythm of BP and HR in relationship with PWV and AIx over 24hours.


We collected anthropometric parameters, clinical history, blood test and echocardiogram in 24 HT patients (12 HT after CTr and HT controls). ABPM, PWV and AIx were recorded over 24 hours with Mobilograph device. The HT+CTr was compared with age/gender matched HT controls. Nonparametric statistic analysis was performed.


The charateristics of CTr and controls had similar age (55±14vs59±12 yrs),gender (9M and 3F), BMI (25,8±5.2vs27,9±4.2 kg/m2) and serum creatinine levels (1,6±0,4vs0,9±0.2). The mean years after transplant were 10.4. 24h BP, MAP and HR were similar in two groups (BP: 128±11.23/78.16±8,23 vs 124.92±14.95/79.16±12.6 MAP: 100,92±7,8vs100±13 mmHg, HR: 74,5±11vs69±10). The same was for daily BP, PWV (8,15±1,8vs8.2±1,3m/s) and Aix (23.6±7.5vs22.8±5.8%) which, however, had not circadian pattern. On the contrary, MAP and HR were higher in CTr during nighttime (101±10.44vs90±10 mmHg, p=0.039; 70,66±11,1 vs 62±9 bpm, p=0.05). Consequentially, no-dipper and inverse phenomenon were higher in CTr(chi-square, p< 0.05).


Our findings show that PWV and AIx haven’t circadian variation. CTr haven’t circadian rhythm of BP and HR also 10 years after trasplant. Thus, cardiac innervation has a crucial role in dipping phenomenon. This does not recover over time.

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Meani, P., Varrenti, M., Giupponi, L. et al. P5.9 Lack of Recovery in Nocturnal Decline of Heart Rate and Blood Pressure After Heart Trasplantation. Artery Res 8, 144 (2014).

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