Autonomic dysfunctions after heart transplantation

Autonomic dysfunctions after heart transplantation

Which autonomic dysfunctions occur following heart transplantation? 

Either heart or heart–lung transplantation results in afferent and efferent denervation (i.e., loss of autonomic control) of the transplanted organ with a relative resting tachycardia, little or no rise in heart rate after standing, and a delayed increase in heart rate in response to exercise.

Also, there are no changes in heart rate with the Valsalva maneuver or carotid sinus massage. In general, the heart rate response in such patients depends on the circulating catecholamines.

The resting tachycardia seen in severe autonomic neuropathies (e.g., diabetes) resembles that seen in a denervated, transplanted heart.

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