Evidence for partial sympathetic cardiac reinnervation following cardiac transplantation

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Abstract
Heart transplantation causes total cardiac denervation. Measurements ofplasma concentrations of the main presynaptic noradrenal metabolite,dihydroxyphenylglycol (DOPEG, exclusively neuronal in origin), were used toexamine the possibility of sympathetic reinnervation of the transplantedhuman heart. We determined arterial and coronary-venous plasmaconcentrations of DOPEG in 15 heart transplant recipients (28-68 years ofage at the time of transplantation with the transplant ageing from 0.5 to 4years at the time of investigation) and in nine control patients (45-75years of age). In each of the control patients the DOPEG concentration washigher in coronary venous plasma than in arterial plasma (meanarteriovenous increment: 60 +/- 10%; P < 0.001). In the heart transplantrecipients nine patients showed an arteriovenous increment in plasma DOPEG.For the mean group results it was found that the ratio of thecoronary-venous to arterial DOPEG concentration was positively correlatedwith the time after transplantation (r = 0.92; n = 5; P < 0.05). Thus,our data provide neurochemical evidence for partial sympatheticreinnervation in some of the heart transplants. Moreover, it is suggestedthat the time after transplantation is unlikely to be the only determinantfor the occurrence and extent of sympathetic reinnervation.

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