Serial Assessment of Sympathetic Reinnervation After Orthotopic Heart Transplantation

Abstract

Background—Little is known about the progressiveness of sympathetic reinnervation late after cardiac transplantation (HTX). The aim of the present study was to describe individual growth of sympathetic terminals after HTX by a longitudinal quantitative assessment. Methods and Results—In 20 patients after HTX, dynamic PET with C-11 hydroxyephedrine (HED) was performed twice within 3.0±0.5 years. According to the time interval between HTX and first PET, subgroups of patients early (group A, 7 years; n=6) after HTX were defined. At the time of first HED PET, 10 patients were completely denervated (7 in group A, 2 in group B, and 1 in group C). Only 3 remained denervated at second PET. A significant increase of reinnervated myocardium between first and second PET was found in all 3 groups (0% to 9±9% of left ventricle for group A, P<0.05; 13±12% to 23±17% for group B, P<0.05; 21±21% to 37±23% for group C, P<0.05). The magnitude ...