Chest pain in cardiac-transplant recipients: evidence of sensory reinnervation after cardiac transplantation

Article Abstract:

Heart transplantation is generally considered to leave the transplanted heart permanently cut off from its sympathetic nerve supply (denervated). Normally, these nerves serve a variety of functions in the heart, including providing its sensory (sensation) supply. However, evidence exists that transplanted hearts are not, in fact, entirely denervated, and five case reports are presented to illustrate this fact. The five patients, who had undergone heart transplantation weeks (in one case) or years (in the others) earlier, developed chest pain or other signs of coronary artery abnormalities. Further investigation revealed that each patient had partial blockage of at least one coronary artery, and that norepinephrine (stored in the nerve terminals of sympathetic nerves) levels were substantial in the two cases where chest pain (angina pectoris) was present. Reinnervation of the heart in animal models of heart transplantation is known to occur, but signs of reinnervation in humans have not been detected. A brief review of the literature concerning this subject is presented. The evidence that sympathetic nerves conduct cardiac pain is evaluated. Since heart transplant patients are known to be at increased risk for coronary artery disease, this possibility should be considered if symptoms of chest pain occur in these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Heart, Heart transplantation, Chest pain

---

Assessing the severity of coronary-artery stenoses

Article Abstract:

It may be time to re-evaluate the effectiveness of coronary angiography in predicting which patients with coronary artery disease have a high risk of a heart attack. During angiography, a dye is injected into the patient's blood to image the coronary arteries using X rays. However, this only reveals the anatomy of the lesions, not their physiological effect. The heart can compensate for lesions by dilating other arteries to keep blood flowing. Measuring blood flow in the arteries may be more effective in determining the extent of coronary artery disease and it is easier to do.

Editorial, Atherosclerosis, Angiography, Coronary arteries

---

Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses

Article Abstract:

Fractional flow reserve (FFR) may be able to predict which patients with moderate coronary artery disease require treatment. FFR measures the amount of blood flowing through a diseased artery compared to the normal amount. In 45 people with moderate coronary artery disease and chest pain, 21 of 24 with a FFR of .75 or higher tested negative for ischemia on four different tests. In contrast, all 21 patients with FFR less than .75 tested positive for ischemia on at least one test. FFR can be easily calculated from various blood pressure readings.

Coronary heart disease, Ischemia, Arteries, Arterial stenosis

Similar abstracts:

• Abstracts: The principles of bone marrow and stem-cell transplantation. Lymphocytic leukaemia: classification and treatment
• Abstracts: Central hemodynamic changes associated with pregnancy in a long-term cardiac transplant recipient. The maternal and neonatal outcome of triplet gestations
• Abstracts: The pharmacokinetics of oxytocin as they apply to labor induction. Operative vaginal delivery - year 2000
• Abstracts: Elevated endothelin levels are associated with increased placental resistance. Defining the role of fluorescence in situ hybridization on uncultured amniocytes for prenatal diagnosis of aneuploidies
• Abstracts: Pulmonary medicine. Pulmonary and critical care medicine

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.