Jandová R, Fabián J
Program výzkumu kardiovaskulárních nemocí, Institutu klinické a experimentální medicíny, Praha.
Cas Lek Cesk. 1990 Jan 5;129(1):15-9.
In a group of 18 patients after orthotopic transplantation of the heart (OTH) operated, 4-56 months previously and treated by combined immunosuppression (Cyclosporin A, corticoids, azathioprine), systemic hypertension was revealed in six and borderline hypertension in three patients. The mechanism of the development of hypertension, after OTH has not been elucidated. As to the circadian rhythm of the blood pressure, as compared with normotensive subjects and patients with essential hypertension, in patients after OTH usually the drop of systemic pressure values does not occur during the night; on the contrary the blood pressure rises during the night. This finding may be due to denervation of the heart after OTH and an abnormal response of baroreceptors to the rise of blood pressure; in this the effect of corticoids may also participate. After a one-year interval the abnormal reaction of the systolic pressure remains preserved, while the 24-hour profile of the diastolic pressure has trend towards normalization.
在一组18例接受原位心脏移植（OTH）手术的患者中，手术时间为4至56个月前，采用联合免疫抑制治疗（环孢素A、皮质类固醇、硫唑嘌呤），发现6例患者出现系统性高血压，3例患者出现临界高血压。OTH后高血压的发生机制尚未阐明。关于血压的昼夜节律，与血压正常者和原发性高血压患者相比，OTH术后患者通常夜间不会出现系统性血压值下降；相反，夜间血压会升高。这一发现可能是由于OTH后心脏去神经支配以及压力感受器对血压升高的异常反应所致；皮质类固醇的作用也可能参与其中。一年后，收缩压的异常反应仍然存在，而舒张压的24小时曲线有趋于正常化的趋势。
