Czubek U C, Piwowarska W
Kliniki Choroby Wieńcowej Instytutu Kardiologii AM w Krakowie.
Pol Tyg Lek. 1994;49(25-26):585-8.
There are significant differences between functioning of transplanted and healthy hearts. Assessment of such a heart and therapeutic possibilities in heart recipients require understanding of these differences. Vegetative denervation of heart increases its sensitivity to the circulation humoral substances, especially catecholamines. In the early postoperative period, filling pressures of the right and left ventricle are elevated. An increase in pulmonary resistance accompany noted pulmonary hypertension, leading subsequently to the right ventricular failure and mitral valve insufficiency. Normalization of these disorders begins in the majority of cases about 4 months following heart transplantation. A type of immunosuppression has an important effect on circulatory hemodynamics. A systemic blood hypertension is a frequent complication of immunosuppression with cyclosporine A in heart recipients. Heart contraction frequency is usually higher in heart recipients than that in control group, and its resting mean value is 90 beats per minute. Moreover, a mild circadian changes in this frequency by about 20% is noted in heart recipients. Cardiac arrhythmias following heart transplantation are associated with the degree of denervated heart transplant to arrhythmia is rather improbable. Cardiac drugs acting with mediation of vegetation system have no effect on the transplanted heart. Heart transplant is fully capable to maintain proper body functioning.
移植心脏与健康心脏的功能存在显著差异。对心脏移植受者的此类心脏进行评估以及探讨治疗可能性需要了解这些差异。心脏的自主神经去支配增加了其对循环体液物质的敏感性,尤其是儿茶酚胺。在术后早期,右心室和左心室的充盈压升高。肺动脉阻力增加伴随明显的肺动脉高压,随后导致右心室衰竭和二尖瓣关闭不全。在大多数情况下,这些紊乱在心脏移植后约4个月开始恢复正常。免疫抑制类型对循环血流动力学有重要影响。系统性高血压是心脏移植受者使用环孢素A进行免疫抑制的常见并发症。心脏移植受者的心脏收缩频率通常高于对照组,其静息平均值为每分钟90次。此外,心脏移植受者的这种频率有轻微的昼夜节律变化,约为20%。心脏移植后的心律失常与去神经支配的心脏移植程度有关,发生心律失常的可能性较小。通过自主神经系统介导起作用的心脏药物对移植心脏无效。心脏移植完全能够维持身体的正常功能。