Degeneration and Regeneration of the Nerves of the Heart After Transplantation

Sinus node function after cardiac surgery: is impairment specific for the maze procedure?

“…The time course of improvement in sinus node function after maze III, mini-maze, and isolated mitral valve surgery would be consistent with delayed autonomic nervous recovery such as is observed after orthotopic heart transplantation [12]. Underlying is late functional and histological reinnervation after initial cardiac denervation [19].…”

Effects of Cardiac Sympathetic Innervation on Coronary Blood Flow

“…Cardiac transplantation results in total cardiac denervation due to the sectioning of the postganglionic neural axons that innervate the heart. 6 Sympathetic reinnervation has been reported after cardiac transplantation, 7,8 but it is only a regional process, favoring the territory of the left anterior descending coronary artery. 8,9 Thus, it is possible to study the degree to which cardiac efferent sympathetic signals alter coronary vasomotion by comparing reinnervated and denervated territories in the same heart independently of changes in hemodynamic factors and circulating catecholamines that modulate coronary blood flow.…”

Evidence for regional catecholamine uptake and storage sites in the transplanted human heart by positron emission tomography.

“…The same authors reported that the functional responses to electro-activation of the nerves were similar to those in normal dogs 3 yr after transplantation (38). Histochemical evaluation of canine cardiac transplants demonstrated regeneration ofadrenergic fibers 1 yr after surgery (13). Kaye et al have reported that reinnervation occurs as early as 3 mo in the canine model using stimulation of the stellate ganglion and measurements of regional myocardial function.…”

“…Reinnervation of transplanted hearts in animals occurs during the first 9-12 mo after surgery (10,(12)(13)(14). However, data demonstrating reinnervation of the human transplanted heart are scarce (10,12).…”