Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Massachusetts General Hospital, Boston, MA, USA.
Eur Heart J. 2018 May 21;39(20):1799-1806. doi: 10.1093/eurheartj/ehw604.
Heart transplantation results in complete denervation of the donor heart with loss of afferent and efferent nerve connections. The majority of patients remain completely denervated during the first 6-12 months following transplantation. Evidence of reinnervation is usually found during the second year after transplantation and involve the myocardial muscle, sinoatrial node, and coronary vessels, but remains incomplete and regionally limited many years post-transplant. Restoration of cardiac innervation can improve exercise capacity as well as blood flow regulation in the coronary arteries, and hence improve quality of life. As yet, there is no evidence that the reinnervation process is associated with the occurrence of allograft-related events or survival.
心脏移植会导致供体心脏完全去神经化，丧失传入和传出神经连接。大多数患者在移植后的头 6-12 个月内仍然完全去神经化。在移植后的第二年通常会发现有再神经支配的证据，涉及心肌、窦房结和冠状动脉，但多年后仍然不完全且局限于局部区域。心脏神经支配的恢复可以改善运动能力以及冠状动脉的血流调节，从而提高生活质量。到目前为止，还没有证据表明再神经支配过程与同种异体移植相关事件或存活有关。
