TY - GEN T1 - Electrocardiographic alterations associated with heart transplantation. Triggers, mechanisms and meaning A1 - Figueroa-Bohórquez, David Mauricio A1 - Benavides, Xiomara A1 - Garzón, Luz A1 - Espinel, Daniel A1 - Suarez, Luis A1 - Uribe, María A1 - Gómez-Aristizabal, Linda A1 - Lozano-Márquez, Eyner Y1 - 2017/// KW - Arrhythmias KW - Bradycardia KW - Cardiac KW - Heart transplantation KW - Tachycardia (MeSH) JF - Revista Facultad de Medicina VL - 65 IS - 3 SP - 483 EP - 489 DO - 10.15446/revfacmed.v65n3.57498 N2 - Introduction: Heart rhythm disorders are associated with increased morbidity and mortality. However, triggers and implications in patients with heart transplantation are not clear. Objectives: The purpose of this research paper is to identify and explain the determinants for the onset of electrical conductivity alterations in patients with a heart transplant, as well as to describe the most common arrhythmias and their pathological implications. Materials and methods: A literature review was made in the PubMed online database for a total of 411 results. In addition, clinical practice guidelines on cardiac transplantation, cardiovascular electrophysiology and infective endocarditis were searched. Sixty articles related to the objectives of this study were chosen. Results: Surgical technique, heart denervation, sinus node trauma, graft rejection, endomyocardial biopsies and infections are the main factors that compromise organ viability and the life of transplanted patients. These factors can be observed as sinus rhythm disturbances. Conclusions: When a cardiac arrhythmia is detected, the medical team must provide a treatment that is not limited to symptomatic and sinus rhythm control. An active search of the etiology must be initiated since it may indicate an underlying pathological process. ER - TY - JOUR T1 - Resolución 8430 de 1993 A1 - Ministerio de Salud Y1 - 1993/// JF - Ministerio de Salud y Protección Social, República de Colombia VL - 1993 IS - Octubre 4 SP - 1 EP - 19 SN - 0000100000030 DO - 10.2353/jmoldx.2008.080023 N2 - Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. ER - TY - JOUR T1 - Trasplante de corazón A1 - H, Alberto Villegas; G, Juan C Jaramillo; J, Gloria Franco Y1 - 2001/// JF - Revista colombiana de cardiologia Vol. 9 Nº 1 Julio/Agosto 2001 VL - 9 SP - 23 EP - 39 N2 - We want to present our experience in 132 cardiac transplants made in 129 patients during a 15 years time period from 1985 until now, in a specialized center in cardiac surgery. The mean age was 44.5 ± (11.8) for the group, with a gender relation of 81% for male population. 50.8% of patients was in functional class III or IV from NYHA. When there were compare the risks factors in the preoperative and intraoperative period against the post- operative complications it was found that the preoperative anticoagulation, prolonged perfusion time (longer than 180 minutes) and the pulmonary hypertension were the risk factors for postoperative complications including dead, having p values of 0.000 When the postoperative complications were analyzed, we found that the long perfusion time and the long drug support had a high statistic correlation with p value = 0.000 Analyzing the survival actuarial curves we found that the long term survival rate was 55.1%, being similar to the report of the International Society of Heart and Lung Trasplantation. (Rev. ER - TY - JOUR T1 - A brain within the heart: A review on the intracardiac nervous system A1 - Durães Campos, Isabel A1 - Pinto, Vitor A1 - Sousa, Nuno A1 - Pereira, Vitor H. Y1 - 2018/// KW - Autonomic nervous system KW - Cardiovascular diseases KW - Intracardiac ganglia KW - Intracardiac nervous system KW - Intracardiac neurons PB - Elsevier JF - Journal of Molecular and Cellular Cardiology VL - 119 IS - December 2017 SP - 1 EP - 9 DO - 10.1016/j.yjmcc.2018.04.005 UR - https://doi.org/10.1016/j.yjmcc.2018.04.005 N2 - Cardiac function is under the control of the autonomic nervous system, composed by the parasympathetic and sympathetic divisions, which are finely tuned at different hierarchical levels. While a complex regulation occurs in the central nervous system involving the insular cortex, the amygdala and the hypothalamus, a local cardiac regulation also takes place within the heart, driven by an intracardiac nervous system. This complex system consists of a network of ganglionic plexuses and interconnecting ganglions and axons. Each ganglionic plexus contains numerous intracardiac ganglia that operate as local integration centres, modulating the intricate autonomic interactions between the extrinsic and intracardiac nervous systems. Herein, we summarize the current understanding on the intracardiac nervous system, and acknowledge its role in the pathophysiology of cardiovascular diseases. ER - TY - JOUR T1 - Guías colombianas de cardiologia - Trasplante cardíaco A1 - Sociedad colombiana de cardiología y cirugía cardiovascular Y1 - 2009/// JF - Revista colombiana de cardiología VL - 16 IS - 2 SP - 20 EP - 69 DO - 0120-5633 ER - TY - JOUR T1 - Decreto Numero 3380 De 1981 Y1 - 1981/// JF - DIARIO OFICIAL 35914 Miércoles 30 diciembre de 1981  DECRETO NUMERO 3380 DE 1981 (noviembre 30)  por el cual se reglamenta la Ley 23 de 1981. VL - 1981 IS - noviembre 30 SP - 1 EP - 6 UR - http://www.mineducacion.gov.co/1621/articles-103328_archivo_pdf.pdf N2 - DIARIO OFICIAL 35914 Miércoles 30 diciembre de 1981 DECRETO NUMERO 3380 DE 1981 (noviembre 30) por el cual se reglamenta la Ley 23 de 1981. El Presidente de la república de Colombia, en ejercicio de las facultades constitucionales conferidas por el artículo 120, numeral 3 de la Constitución Política, DECRETA: Del juramento. Artículo 1º. Las autoridades académicas o sus delegados que confieran los títulos de médicos, tomarán el juramento médico. De las relaciones del médico con el paciente. Artículo 2º. En el trabajo institucional el derecho de libre elección del médico por parte del paciente estará sujeto a las posibilidades ofrecidas por cada institución. Artículo 3º. Para señalar la responsabilidad médica frente a los casos de emergencia o urgencia, entíendese por ésta, todo tipo de afección que ponga en peligro la vida o integridad de la persona y que requiera atención inmediata de acuerdo con el dictamen médico. Artículo 4º. Con excepción de los casos de urgencia, el médico podrá excusarse de asistir a un enfermo o interrumpir la prestación de sus servicios por las siguientes causas; a) Si se comprueba que le caso n corresponde a su especialidad, previo exámen general; b) Que el paciente reciba la atención de otro profesional que excluya la suya sin su previo consentimiento; c) Que el enfermo rehusé cumplir las indicaciones prescritas, entendiéndose por éstas, no sólo la formulación de tratamientos sino también los exámenes, juntas médicas, interconsultas y otras indicaciones generales que pro su no realización afecten la salud del paciente. Artículo 5º. El médico respetará la liberad del enfermo para prescindir de sus servicios, siempre y cuando el paciente tenga capacidad de manifestar su libre albedrío. ER - TY - JOUR T1 - The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report—2017; Focus Theme: Allograft ischemic time A1 - Lund, Lars H. A1 - Khush, Kiran K. A1 - Cherikh, Wida S. A1 - Goldfarb, Samuel A1 - Kucheryavaya, Anna Y. A1 - Levvey, Bronwyn J. A1 - Meiser, Bruno A1 - Rossano, Joseph W. A1 - Chambers, Daniel C. A1 - Yusen, Roger D. A1 - Stehlik, Josef Y1 - 2017/// PB - Elsevier Inc. JF - Journal of Heart and Lung Transplantation VL - 36 IS - 10 SP - 1037 EP - 1046 SN - 1557-3117 (Electronic) 1053-2498 (Linking) DO - 10.1016/j.healun.2017.07.019 UR - http://dx.doi.org/10.1016/j.healun.2017.07.019 N2 - This year marks the 50th anniversary of the first heart transplant, performed in 1967. Since then, and in particular since the introduction of cyclosporine immunosuppression in the 1970s, heart transplantation has grown worldwide. This 34th adult heart transplant report is based on data submitted to the International Society for Heart and Lung Transplantation (ISHLT) Registry on 135,387 heart trans-plants in recipients of all ages (including 120,991 adult heart transplants) through June 30, 2016. With each year's report we now also provide more detailed analyses on a particular focus theme. Since 2013, these have been donor and recipient age, retransplantation, early graft failure, indication for transplant, and in 2017, allograft ischemic time. ER - TY - JOUR T1 - AAEM minimonograph 48: Autonomic nervous system testing A1 - Ravits, John M. Y1 - 1997/// KW - 30:15 ratio KW - Autonomic function KW - Head-up tilt-table testing KW - Quantitative sudomotor axon reflex KW - Sinus arrhythmia KW - Sweat imprint test KW - Sympathetic skin response KW - Thermoregulatory sweat test KW - Valsalva ratio JF - Muscle and Nerve VL - 20 IS - 8 SP - 919 EP - 937 SN - 0148-639X (Print)\n0148-639x DO - 10.1002/(SICI)1097-4598(199708)20:8<919::AID-MUS1>3.0.CO;2-9 N2 - The autonomic nervous system maintains internal homeosta-sis by regulating cardiovascular, thermoregulatory, gastrointestinal, genito-urinary, exocrine, and pupillary function. Testing and quantifying autonomic nervous system function is an important but difficult area of clinical neuro-physiology. Tests of parasympathetic cardiovagal regulation include heart rate analysis during standing (the 30:15 ratio), heart rate variation with deep breathing, and the Valsalva ratio. Tests of sympathetic adrenergic vascular regulation include blood pressure analysis while standing, the Valsalva maneuver, sustained handgrip, mental stress, and cold water immersion. Tests of sympathetic cholinergic sudomotor function include the sympathetic skin response, quantitative sudomotor axon reflex test, sweat box testing, and quantification of sweat imprints. Pupil function is tested pharmacol-ogically and with pupillographic techniques. Tests of gastrointestinal and genitourinary function do not satisfactorily isolate autonomic regulation from their other functions. The available tests have various sensitivities and ease of administration. They are typically administered in a battery of mult-iple tests, which improves sensitivity and reliability, and allows probing of various autonomic functions. ER - TY - JOUR T1 - Variabilidad de la frecuencia cardiaca y alteraciones del ritmo cardiaco asociados a la terapia con células progenitoras en enfermedad cardiovascular A1 - Orrego, Carlos M A1 - Astudillo, Boris V A1 - Senior, Juan M A1 - Cuéllar, Francisco A1 - Velásquez, Óscar A1 - Velásquez, Margarita Y1 - 2007/// KW - arritmias ventriculares KW - cardiaca KW - cardiopatía isquémica KW - colombia KW - de paúl - KW - hospital universitario san vicente KW - la médula ósea KW - medellín KW - sdnn KW - trasplante autólogo derivado de KW - trasplantes KW - unidad cardiovascular y de KW - universidad de antioquia KW - variabilidad de la frecuencia VL - 14 IS - 6 SP - 353 EP - 358 ER - TY - JOUR T1 - The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update A1 - Mehra, Mandeep R. A1 - Canter, Charles E. A1 - Hannan, Margaret M. A1 - Semigran, Marc J. A1 - Uber, Patricia A. A1 - Baran, David A. A1 - Danziger-Isakov, Lara A1 - Kirklin, James K. A1 - Kirk, Richard A1 - Kushwaha, Sudhir S. A1 - Lund, Lars H. A1 - Potena, Luciano A1 - Ross, Heather J. A1 - Taylor, David O. A1 - Verschuuren, Erik A.M. A1 - Zuckermann, Andreas Y1 - 2016/// PB - Elsevier JF - Journal of Heart and Lung Transplantation VL - 35 IS - 1 SP - 1 EP - 23 SN - 1557-3117 (Electronic) 1053-2498 (Linking) DO - 10.1016/j.healun.2015.10.023 UR - http://dx.doi.org/10.1016/j.healun.2015.10.023 N2 - ...patients with improved renalfunction after VAD support generally maintain renalfunction after HT. However...patients with severe renaldysfunction at the time...substance abuse, and psychosocialevaluation in candidate...Any patient for whom socialsupports are deemed insufficient... ER - TY - JOUR T1 - The Past, Present and Future of Heart Transplantation A1 - Kim, In-Cheol A1 - Youn, Jong-Chan A1 - Kobashigawa, Jon A. Y1 - 2018/// JF - Korean Circulation Journal VL - 48 IS - 7 SP - 565 EP - 565 DO - 10.4070/kcj.2018.0189 UR - https://synapse.koreamed.org/DOIx.php?id=10.4070/kcj.2018.0189 ER - TY - JOUR T1 - How heterogeneous is the cardiac autonomic innervation? A1 - Momose, Mitsuru A1 - Tyndale-Hines, Leisha A1 - Bengel, Frank Michael A1 - Schwaiger, Markus Y1 - 2001/// JF - Basic Research in Cardiology VL - 96 IS - 6 SP - 539 EP - 546 DO - 10.1007/s003950170004 UR - http://link.springer.com/10.1007/s003950170004 ER - TY - JOUR T1 - Resolucion Numero 1995 De 1999 A1 - Salud, Ministerio de Y1 - 1999/// JF - Republica de colombia VL - 1999 IS - Julio 8 SP - 1 EP - 8 SN - 4917754933 N2 - POR LA CUAL SE ESTABLECEN NORMAS PARA EL MANEJO DE LA HISTORIA CLINICA ER - TY - JOUR T1 - Prognostic Significance of Heart Rate and its Long-term Trend in Cardiac Transplant Patients A1 - Barge-Caballero, Eduardo A1 - Jiménez-López, Jesús A1 - Chávez-Leal, Sergio A1 - Barge-Caballero, Gonzalo A1 - Paniagua-Martin, María Jesús A1 - Marzoa Rivas, Raquel A1 - Grille-Cancela, Zulaika A1 - Cuenca-Castillo, José Joaquín A1 - Castro-Beiras, Alfonso A1 - Crespo-Leiro, María G. Y1 - 2015/// KW - Frecuencia cardiaca KW - Heart rate KW - Prognosis KW - Pronóstico KW - Transplantation KW - Trasplante JF - Revista espanola de cardiologia (English ed.) VL - 68 IS - 11 SP - 943 EP - 950 DO - 10.1016/j.rec.2014.09.028 N2 - INTRODUCTION AND OBJECTIVES: The aim of the present study was to examine the prognostic significance of heart rate and its trend in heart transplantation. METHODS: This observational study enrolled 170 patients who received a bicaval heart transplant between 1995 and 2005; all were in sinus rhythm. The resting heart rate was determined via electrocardiography at the end of the first posttransplant year and annually until the tenth year. Cox analysis was used to evaluate the incidence of adverse events with a mean (standard deviation) follow-up of 8.9 (3.1) years. The primary study end point was the composite outcome of death or graft dysfunction. RESULTS: The resting heart rate at the end of the first posttransplant year was an independent predictor of the primary composite end point (hazard ratio=1.054; 95% confidence interval, 1.028-1.080; P<.001) and was significantly associated with total mortality (hazard ratio=1.058; 95% confidence interval, 1.030-1.087; P<.001) and mortality from cardiac causes (hazard ratio=1.069; 95% confidence interval, 1.026-1.113; P=.001), but not with graft dysfunction (hazard ratio=1.028; 95% confidence interval, 0.989-1.069; P=.161). For patients with a heart rate ≥ 105 or<90 bpm vs those with 90-104 bpm, the hazard ratios of the primary end point were 2.233 (95% confidence interval, 1.250-3.989; P=.007) and 0.380 (95% confidence interval, 0.161-0.895; P=.027), respectively. Heart rate tended to decrease in the first 10 years after transplantation (P=.001). Patients with a net increase in heart rate during follow-up showed a higher incidence of adverse events. CONCLUSIONS: An elevated heart rate is an adverse prognostic marker after heart transplantation. ER - TY - JOUR T1 - Ley 100 de 1993 A1 - Ministerio de salud y protección social Y1 - 1993/// JF - Ley VL - 100 IS - 41 SP - 500 EP - 500 SN - 9788578110796 DO - 10.1017/CBO9781107415324.004 UR - https://docs.supersalud.gov.co/PortalWeb/Juridica/Leyes/L0100_93.pdf N2 - (Diciembre 23) Diario Oficial No. 41.148 de 23 de diciembre de 1993 Por la cual se crea el sistema de seguridad social integral y se dictan otras disposiciones NOTAS DE VIGENCIA: -Modificada por la Ley 1702 de 2013, "por la cual se crea la agencia nacional de seguridad vial y se dictan otras disposiciones", publicada en el Diario Oficial No. 49.016 de 27 de diciembre de 2013. -Modificado por la Ley 1607 de 2012, "por la cual se expiden normas en materia tributaria y se dictan otras disposiciones", publicada en el Diario Oficial No. 48.655 de 26 de diciembre de 2012 -Modificada por la Ley 1580 de 2012, "por la cual se crea la pensión familiar", publicada en el Diario Oficial No. 48.570 de 1 de octubre de 2012 -Modificado por la Ley 1562 de 2012, publicada en el Diario Oficial No. 48.488 de 11 de julio de 2012, "Por la cual se modifica el Sistema de Riesgos Laborales y se dictan otras disposiciones en materia de Salud Ocupacional" -Modificada por el Decreto 19 de 2012, publicado en el Diario Oficial No. 48.308 de 10 de enero de 2012, "Por el cual se dictan normas para suprimir o reformar regulaciones, procedimientos y trámites innecesarios existentes en la Administración Pública" -Modificada por el Decreto 4465 de 2011, publicado en el Diario Oficial No. 48.264 de 25 de noviembre de 2011, "Por el cual se adopta un mecanismo transitorio para garantizar la afiliación al Régimen Contributivo del Sistema General de Seguridad Social en Salud" -Modificada por la Ley 1450 de 2011, publicada en el Diario Oficial No. 48.102 de 16 de junio de 2011, "Por la cual se expide el Plan Nacional de Desarrollo, 2010-2014" -Modificada por la Ley 1438 de 2011, publicada en el Diario Oficial No. 47. 957 de 19 de enero de 2011, "Por medio de la cual se reforma el Sistema General de Seguridad Social en Salud y se dictan otras disposiciones" -Modificada por el Decreto 132 de 2010, publicado en el Diario Oficial No. 47.599 de 21 de enero de 2010, "Por el cual se establecen mecanismos para administrar y optimizar el flujo de recursos que financian el Régimen Subsidiado de Salud del Sistema General de Seguridad Social en Salud y se dictan otras disposiciones". Decreto expedido bajo el estado de emergencia social decretado mediante el Decreto 4975 de 2009. INEXEQUIBLE. 37. Modificada por el Decreto 131 de 2010, publicado en el Diario Oficial No. 47.599 de 21 de enero de 2010, "Por medio del cual se crea el Sistema Técnico Científico en Salud, se regula la autonomía profesional y se definen aspectos del aseguramiento del Plan Obligatorio de Salud y se dictan otras disposiciones". Decreto expedido bajo el estado de emergencia social decretado mediante el Decreto 4975 de 2009. INEXEQUIBLE. 36. Modificada por el Decreto 128 de 2010, publicado en el Diario Oficial No. 47.599 de 21 de enero de 2010, "Por medio del cual se regulan las prestaciones excepcionales en salud y se dictan otras disposiciones". Decreto expedido bajo el estado de emergencia social decretado mediante el Decreto 4975 de 2009. INEXEQUIBLE. ER - TY - JOUR T1 - Early denervation and later reinnervation of the heart following cardiac transplantation: A review A1 - Awad, Morcos A1 - Czer, Lawrence S.C. A1 - Hou, Margaret A1 - Golshani, Sarah S. A1 - Goltche, Michael A1 - De Robertis, Michele A1 - Kittleson, Michelle A1 - Patel, Jignesh A1 - Azarbal, Babak A1 - Kransdorf, Evan A1 - Esmailian, Fardad A1 - Trento, Alfredo A1 - Kobashigawa, Jon A. Y1 - 2016/// KW - Electrophysiology KW - Exercise KW - Hemodynamics KW - Imaging KW - Nervous system autonomic KW - Transplantation JF - Journal of the American Heart Association VL - 5 IS - 11 SP - 1 EP - 22 DO - 10.1161/JAHA.116.004070 ER - TY - JOUR T1 - Informe Ejecutivo Red De Donación Y Trasplantes A1 - SALUD, INSTITUTO NACIONAL DE Y1 - 2015/// KW - Mobile KW - Named entity disambiguation KW - Natural language processing KW - News KW - Recommender system JF - CEUR Workshop Proceedings VL - 1542 IS - 9 SP - 33 EP - 36 SN - 9788578110796 DO - 10.1017/CBO9781107415324.004 N2 - Predicting the binding mode of flexible polypeptides to proteins is an important task that falls outside the domain of applicability of most small molecule and protein−protein docking tools. Here, we test the small molecule flexible ligand docking program Glide on a set of 19 non-α-helical peptides and systematically improve pose prediction accuracy by enhancing Glide sampling for flexible polypeptides. In addition, scoring of the poses was improved by post-processing with physics-based implicit solvent MM- GBSA calculations. Using the best RMSD among the top 10 scoring poses as a metric, the success rate (RMSD ≤ 2.0 Å for the interface backbone atoms) increased from 21% with default Glide SP settings to 58% with the enhanced peptide sampling and scoring protocol in the case of redocking to the native protein structure. This approaches the accuracy of the recently developed Rosetta FlexPepDock method (63% success for these 19 peptides) while being over 100 times faster. Cross-docking was performed for a subset of cases where an unbound receptor structure was available, and in that case, 40% of peptides were docked successfully. We analyze the results and find that the optimized polypeptide protocol is most accurate for extended peptides of limited size and number of formal charges, defining a domain of applicability for this approach. ER - TY - JOUR T1 - Sympathetic reinnervation of sinus node and left ventricle after heart transplantation in humans: Regional differences assessed by heart rate variability and positron emission tomography A1 - Überfuhr, Peter A1 - Frey, Axel W. A1 - Ziegler, Sibylle A1 - Reichart, Bruno A1 - Schwaiger, Markus Y1 - 2000/// JF - Journal of Heart and Lung Transplantation VL - 19 IS - 4 SP - 317 EP - 323 SN - 1053-2498 (Print)\r1053-2498 (Linking) DO - 10.1016/S1053-2498(00)00060-7 N2 - Background: Orthotopic heart transplantation (HTx) results in complete cardiac denervation. Reestablished partial sympathetic nerve function has been found in patients some years after HTx. However, the atrial and ventricular regional patterns of reinnervation have not been established. Methods: Two parallel methods were used to evaluate the regional restoration of sympathetic nerves in the myocardium. Patients were investigated with respect to ventricular reinnervation (VI) using positron emission tomography (PET) and the norepinephrine analogue C-11-hydroxyephedrine (HED). Tracer uptake was quantified using dynamic imaging protocols, yielding regional HED retention fraction. A regional value above 7%/minute ( ± 2.5 SD above the mean value of denervated hearts) was considered evidence of sympathetic reinnervation. Spectral analysis of heart rate variability (HRV) served as a quantitative marker for reinnervation at the sinus node (SI). Spectra of HRV during positive head-up tilt were calculated. The low frequency (LF) power spectral density (0.05 to 0.18 Hz) was evaluated. Results. After HTx (4.6 ± 3.9 years; range, 0.2 to 13.6 years), 38 patients (aged 50.9 ± 7.6 years; range, 37 to 65 years) were investigated by PET imaging and HRV. Twenty-two patients with a mean HED retention of 10.7 ± 2.6%/minute were classified as left ventricular reinnervated. Sixteen patients with a mean HED retention of 4.8 ± 0.8%/minute did not reach the threshold. The time difference after HTx was significant for these 2 groups, 5.3 ± 3.0 years vs 3.8 ± 4.7 years ( p < 0.05 ). The LF power spectral density of the ventricular reinnervated patients was 5.9 ± 8.6 ms2, and 1.8 ± 4.4 ms2(p <0.005 ) for those not reinnervated . Low frequency showed small values and narrow distribution for the patients not reinnervated, assuming sinus node denervation, and showed extended distribution for the reinnervated, suggesting a heterogeneous reinnervation pattern. Conclusion: Two non-invasive parallel methods were used to investigate regional reestablishment of cardiac nerves in the myocardium in HTx patients. Left VI assessed by PET imaging and SI by HRV was congruent in 60% of HTx patients. Lack of SI paralleled absence of VI. Our results suggest that partial VI occurs prior to SI. Copyright (C) 2000 International Society for Heart and Lung Transplantation. ER - TY - JOUR T1 - Heart rate variability: Standards of Measurement, Physiological A1 - Guidelines Y1 - 1996/// KW - american KW - autonomic nervous system KW - co-sponsored by the north KW - computers KW - electrocardiography KW - established by the board KW - heart rate KW - of the european KW - risk factors KW - society of cardiology and KW - the task force was JF - European Heart Journal VL - 17 SP - 354 EP - 381 SN - 0195-668X DO - 10.1161/01.CIR.93.5.1043 UR - http://www.mendeley.com/research/guidelines-heart-rate-variability-2/ N2 - The last two decades have witnessed the recognition of a significant relationship between the autonomic nervous system and cardiovascular mortality, including sudden cardiac death[1–4]. Experimental evidence for an associ- ation between a propensity for lethal arrhythmias and signs of either increased sympathetic or reduced vagal activity has encouraged the development of quantitative markers of autonomic activity. Heart rate variability (HRV) represents one of the most promising such markers. The apparently easy derivation of this measure has popularized its use. As many commercial devices now provide automated measurement of HRV, the cardiologist has been pro- vided with a seemingly simple tool for both research and clinical studies[5]. However, the significance and meaning of the many different measures of HRV are more complex than generally appreciated and there is a potential for incorrect conclusions and for excessive or unfounded extrapolations. Recognition of these problems led the European Society of Cardiology and the North American Society ER - TY - JOUR T1 - Heart rate variability after heart transplantation : A 10-year longitudinal follow-up study A1 - Cornelissen, Véronique A A1 - Vanhaecke, Johan A1 - Aubert, André E A1 - Fagard, Robert H Y1 - 2012/// PB - Japanese College of Cardiology JF - Journal of Cardiology VL - 59 IS - 2 SP - 220 EP - 224 DO - 10.1016/j.jjcc.2011.12.002 UR - http://dx.doi.org/10.1016/j.jjcc.2011.12.002 ER - TY - JOUR T1 - Reinnervation post-Heart transplantation A1 - Grupper, Avishay A1 - Gewirtz, Henry A1 - Kushwaha, Sudhir Y1 - 2017/// KW - heart transplantation JF - European Heart Journal IS - March SP - ehw604 EP - ehw604 DO - 10.1093/eurheartj/ehw604 UR - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehw604 ER - TY - JOUR T1 - Honoring 50 Years of Clinical Heart Transplantation in Circulation A1 - Stehlik, Josef A1 - Kobashigawa, Jon A1 - Hunt, Sharon A. A1 - Reichenspurner, Hermann A1 - Kirklin, James K. Y1 - 2018/// KW - heart transplantation KW - immunosuppression KW - survival JF - Circulation VL - 137 IS - 1 SP - 71 EP - 87 DO - 10.1161/CIRCULATIONAHA.117.029753 UR - http://circ.ahajournals.org/lookup/doi/10.1161/CIRCULATIONAHA.117.029753 ER - TY - GEN T1 - Performance Limitations in Heart Transplant Recipients A1 - Tucker, Wesley J A1 - Beaudry, Rhys I A1 - Haykowsky, Mark J A1 - Samuel, T Jake A1 - Nelson, Michael D A1 - Halle, Martin A1 - Baggish, Aaron L KW - Physiology KW - Sport Sciences KW - cardiac reinnervation KW - cardiovascular function KW - exercise training KW - peak oxygen uptake KW - skeletal muscle function JF - EXERCISE AND SPORT SCIENCES REVIEWS VL - 46 IS - 3 SP - 144 EP - 151 SN - 00916331 UR - http://ez.urosario.edu.co/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edswsc&AN=000435347100003&lang=es&site=eds-live&scope=site N2 - We hypothesize that the reduced peak aerobic power (peak VO2) after heart transplantation is due to impaired cardiovascular and skeletal muscle function, and its improvement with short-term (<= 1 yr) exercise training is primarily due to favorable skeletal muscle adaptations. Furthermore, the increased peak VO2 with long-term (>2 yr) training is primarily mediated by cardiac (sympathetic) reinnervation. ER - TY - JOUR T1 - UK guidelines for referral and assessment of adults for heart transplantation A1 - Banner, Nicholas R. A1 - Bonser, Robert S. A1 - Clark, Andrew L. A1 - Clark, Stephen A1 - Cowburn, Peter J. A1 - Gardner, Roy S. A1 - Kalra, Paul R. A1 - McDonagh, Theresa A1 - Rogers, Chris A. A1 - Swan, Lorna A1 - Parameshwar, Jayan A1 - Thomas, Helen L. A1 - Williams, Simon G. Y1 - 2011/// JF - Heart VL - 97 IS - 18 SP - 1520 EP - 1527 SN - 1468-201X (Electronic)\n1355-6037 (Linking) DO - 10.1136/heartjnl-2011-300048 N2 - Patients with advanced heart failure have a dismal prognosis and poor quality of life. Heart transplantation provides an effective treatment for a subset of these patients. This article provides cardiologists with up-to-date information about referral for transplantation, the role of left ventricular assist devices prior to transplant, patient selection, waiting-list management and donor heart availability. Timing is of central importance; patients should be referred before complications (eg, cardiorenal syndrome or secondary pulmonary hypertension) have developed that will increase the risk of, or potentially contraindicate, transplantation. Issues related to heart failure aetiology, comorbidity and adherence to medical treatment are reviewed. Finally, the positive role that cardiologists can play in promoting and facilitating organ donation is discussed. ER - TY - JOUR T1 - Código de Ética Médica. Colombia A1 - Kraus, Arnoldo Y1 - 1996/// KW - Ética médica JF - Nexos VL - 19 IS - 223 SP - 30 EP - 33 SN - 8433561219 N2 - Esta Secção visa ressaltar os aspectos éticos envolvidos em condutas adotadas em casos clínicos, de preferência reais. Faz-se a descrição de um caso clínico, solicitando-se a opinião de profissionais reconhecidamente competentes. Para garantir a utilidade social e acadêmica da Secção, os responsáveis solicitam e agradecem a contribuição dos leitores. Espera-se receber casos reais para discussão, comentários relativos às posições dos profissionais selecionados e informações que possibilitem o exame ético dessas mesmas posições. ER - TY - JOUR T1 - Reinnervation of the transplanted human heart as evidenced from heart rate variability studies A1 - Halpert, I. A1 - Goldberg, A. D. A1 - Levine, A. B. A1 - Levine, T. B. A1 - Kornberg, R. A1 - Kelly, C. A1 - Lesch, M. Y1 - 1996/// JF - American Journal of Cardiology VL - 77 IS - 2 SP - 180 EP - 183 SN - 0002-9149 (Print)\r0002-9149 (Linking) DO - 10.1016/S0002-9149(96)90592-5 N2 - This study evaluated heart rate variability (HRV) after cardiac transplantation in humans in an attempt to test the hypothesis that cardiac reinnervation occurs in the post-transplant period. HRV was measured using 24-hour Holter recordings performed on 37 ambulant patients 1 to 122 months after cardiac transplantation. All patients were free of histologic rejection and were taking no medication likely to influence HRV. Time and frequency domain were analyzed and circadian rhythm of hourly average heart rate was calculated. HRV increased with time after the transplant. Compared with patients in the early post-transplant period, patients >36 months after transplant had lower 24-hour heart rates (86 vs 93 beats/min), an increased average of all 5-minute SDs of NN intervals (17.6 vs 11.3), and higher low- and high-frequency power. Ten of the 27 patients >3 years after transplantation had evidence of functional cardiac reinnervation. Compared with patients who had no reinnervation, these patients had increased circadian variability with lower nocturnal heart rates (76 vs 91 beats/min) and greater sympathetic activity during both daytime (natural logarithm sympathetic power-0.36 vs-1.45) and nighttime (natural logarithm sympathetic power -0.43 vs -1.98). Despite lower nocturnal heart rates, them was no HRV evidence for an increase in parasympathetic ability. Thus, patients late after cardiac transplantation have HRV evidence for an increase in sympathetic control of the heart. ER - TY - JOUR T1 - Analysis of Heart Rate Variability With Electromyography in Heart Transplant Recipients A1 - On, Arzu A1 - Karapolat, Hale A1 - Zoghi, Mehdi A1 - Nalbantgil, Sanem A1 - Yagdi, Tahir A1 - Ozbaran, Mustafa Y1 - 2009/// KW - Heart transplantation KW - Rehabilitation PB - Elsevier Inc. JF - Archives of Physical Medicine and Rehabilitation VL - 90 IS - 9 SP - 1635 EP - 1638 DO - 10.1016/j.apmr.2009.03.012 UR - http://dx.doi.org/10.1016/j.apmr.2009.03.012 N2 - On A, Karapolat H, Zoghi M, Nalbantgil S, Yagdi T, Ozbaran M. Analysis of heart rate variability with electromyography in heart transplant recipients. Objective: To investigate vagal parasympathetic functions by electromyographic R-R interval variation analyses in heart transplant recipients. Design: Cross-sectional and longitudinal study. Setting: Department of physical medicine and rehabilitation, university hospital. Participants: Early (n=8; <3mo) and late (n=17; >1y) heart transplant recipients and healthy volunteers (n=20) were included. Interventions: Not applicable. Main Outcome Measures: The R-R interval variations at rest and in response to deep breathing, Valsalva, and tilt/standup maneuvers were analyzed in all patient and control groups. Further, 8 early heart transplant recipients were followed up at the sixth and twelfth months after transplantation. Results: Compared with controls, both early and late transplant recipients had significantly lower R-R interval variation ratios (P<.05). There were no statistically significant differences between the early and late groups (P>.05). R-R interval variation ratios showed no significant changes from baseline (P>.025) in the early heart transplant recipients. Conclusions: The findings of the study suggest that parasympathetic activities are suppressed in the early stage after heart transplantation and do not significantly recover with time. The electromyographic analysis of R-R interval variation is a simple test that may offer an attractive alternative for routine evaluation of autonomic dysfunction in heart transplant recipients. © 2009 American Congress of Rehabilitation Medicine. ER - TY - BOOK T1 - Heart Rate Variability A1 - Electrophysiology, Task Force of the European Society Y1 - 1996/// KW - Heart rate variability KW - Sydämen sykevaihtelu KW - atherosclerosis KW - autonomic cardiac control KW - autonomic nervous system KW - autonominen hermosto KW - metabolic syndrome KW - metabolinen oireyhtymä KW - reference values KW - valtimonkovettumatauti KW - viitearvot JF - Circulation VL - 93 IS - 5 SP - 1043 EP - 1065 SN - 0195-668X DO - 10.1161/01.CIR.93.5.1043 UR - https://www.ahajournals.org/doi/10.1161/01.CIR.93.5.1043 ER - TY - JOUR T1 - Declaración de Helsinki A1 - Valdespino Gómez, J. L. A1 - García García, M. D.L. Y1 - 2001/// JF - Gaceta Medica de Mexico VL - 137 IS - 4 SP - 391 EP - 391 SN - 1549-1676 (Electronic)\r1549-1277 (Linking) DO - 10.1177/1524839913507280 N2 - Principios éticos para las investigaciones médicas en seres humanos Adoptada por la 18.ª Asamblea Médica Mundial Helsinki, Finlandia, junio 1964 y enmendada por la 29.ª Asamblea Médica Mundial Tokio, Japón, octubre 1975 35.ª Asamblea Médica Mundial Venecia, Italia, octubre 1983 41.ª Asamblea Médica Mundial Hong Kong, septiembre 1989 48.ª Asamblea General Somerset West, Sudáfrica, octubre 1996 y la 52.ª Asamblea General Edimburgo, Escocia, octubre 2000 Nota de Clarificación del Párrafo 29, agregada por la Asamblea General de la AMM, Washington 2002 Nota de Clarificación del Párrafo 30, agregada por la Asamblea General de la AMM, Tokio 2004 ER - TY - JOUR T1 - Recurrence Plots: a New Tool for Quantification of Cardiac Autonomic Nervous System Recovery after Transplant A1 - Takakura, Isabela Thomaz A1 - Hoshi, Rosangela Akemi A1 - Santos, Márcio Antonio A1 - Pivatelli, Flávio Correa A1 - Nóbrega, João Honorato A1 - Guedes, Débora Linhares A1 - Nogueira, Victor Freire A1 - Frota, Tuane Queiroz A1 - Castelo, Gabriel Castro A1 - Godoy, Moacir Fernandes de Y1 - 2017/// KW - autonomic nervous KW - heart failure KW - transplantation JF - Brazilian Journal of Cardiovascular Surgery VL - 32 IS - 4 SP - 245 EP - 252 DO - 10.21470/1678-9741-2016-0035 UR - http://www.bjcvs.org/index N2 - Objective: To evaluate a possible evolutionary post-heart transplant return of autonomic function using quantitative and qualitative information from recurrence plots. Methods: Using electrocardiography, 102 RR tachograms of 45 patients (64.4% male) who underwent heart transplantation and that were available in the database were analyzed at different follow-up periods. The RR tachograms were collected from patients in the supine position for about 20 minutes. A time series with 1000 RR intervals was analyzed, a recurrence plot was created, and the following quantitative variables were evaluated: percentage of determinism, percentage of recurrence, average diagonal length, Shannon entropy, and sample entropy, as well as the visual qualitative aspect. Results: Quantitative and qualitative signs of heart rate variability recovery were observed after transplantation. Conclusion: There is evidence that autonomic innervation of the heart begins to happen gradually after transplantation. Quantitative and qualitative analyses of recurrence can be useful tools for monitoring cardiac transplant patients and detecting the gradual return of heart rate variability. Abbreviations, acronyms & symbols AF ApEn CD DET DFA ENTR HRV LAM Lmax Lmean REC RPs RR SampEn ShEn TT = Atrial fibrillation = Approximate entropy = Correlation dimension = Determinism = Detrended fluctuations analysis = Entropy = Heart rate variability = Laminarity = Maximum line = Average diagonal length = Recurrence = Recurrence plots = RR intervals = Sample entropy = Shannon entropy = Trapping time ER - TY - JOUR T1 - Ley Estatutaria 1581 De 2012 A1 - Soediono, Budi Y1 - 1989/// KW - icle JF - Journal of Chemical Information and Modeling VL - 53 IS - Octubre 17 SP - 160 EP - 160 SN - 9788578110796 DO - 10.1017/CBO9781107415324.004 N2 - Predicting the binding mode of flexible polypeptides to proteins is an important task that falls outside the domain of applicability of most small molecule and protein−protein docking tools. Here, we test the small molecule flexible ligand docking program Glide on a set of 19 non-α-helical peptides and systematically improve pose prediction accuracy by enhancing Glide sampling for flexible polypeptides. In addition, scoring of the poses was improved by post-processing with physics-based implicit solvent MM- GBSA calculations. Using the best RMSD among the top 10 scoring poses as a metric, the success rate (RMSD ≤ 2.0 Å for the interface backbone atoms) increased from 21% with default Glide SP settings to 58% with the enhanced peptide sampling and scoring protocol in the case of redocking to the native protein structure. This approaches the accuracy of the recently developed Rosetta FlexPepDock method (63% success for these 19 peptides) while being over 100 times faster. Cross-docking was performed for a subset of cases where an unbound receptor structure was available, and in that case, 40% of peptides were docked successfully. We analyze the results and find that the optimized polypeptide protocol is most accurate for extended peptides of limited size and number of formal charges, defining a domain of applicability for this approach. ER - TY - JOUR T1 - Angina secundaria a lesión de tronco coronario izquierdo post trasplante cardiaco. Evidencias de reinervación simpática tardía A1 - Riedemann S, Erick A1 - Castro G, Pablo A1 - Quintana F, Juan Carlos A1 - Pérez P, Osvaldo A1 - Mc-Nab M, Paul Y1 - 2007/// KW - Coronary artery bypass KW - Coronary disease KW - Heart transplantation JF - Revista Medica de Chile VL - 135 IS - 12 SP - 1577 EP - 1581 N2 - We report a 56 years-old man presenting with chest pain with exercise, seven years after an orthotopic heart transplant. A coronary angiography showed an atherosclerotic lesion in the common left main coronary artery with more than 90 percent obstruction. The lesion was successfully treated with a transluminal angioplasty with stenting. A 131-1 metaiodobenylguanidine (MIBG) scan demonstrated sympathetic reinnervation. Sixteen months later, due to progression of allograft vasculopathy, coronary artery bypass was required.(AU) ER - TY - JOUR T1 - The use of heart rate variability measures as indicators of autonomic nervous modulation must be careful in patients after orthotopic heart transplantation A1 - Lu, Wan An A1 - Chen, Gau Yang A1 - Shih, Chun Che A1 - Kuo, Cheng Deng Y1 - 2016/// KW - Autonomic nervous system KW - Heart rate variability KW - Heart transplantation KW - Re-innervation PB - Springer Netherlands JF - Journal of Clinical Monitoring and Computing VL - 30 IS - 5 SP - 687 EP - 697 SN - 1573-2614 (Electronic)\r1387-1307 (Linking) DO - 10.1007/s10877-015-9747-y N2 - © 2015 The Author(s) The precise relation between heart rate variability (HRV) and autonomic re-innervation has not been established explicitly in patients after orthotopic heart transplantation (OHT), but can be inferred from the fact that the HRV is reduced immediately after OHT and may increase gradually with time. The aim of this study was to investigate the residual HRV in patients about 1–2 years after OHT, as compared with patients after coronary artery bypass graft (CABG) surgery. Thirteen patients who had received OHT and 14 patients who had received CABG surgery were recruited. HRV analysis was performed and the HRV measures in supine position were compared between these two groups of patients. We found that the mean (mRRI), standard deviation and coefficient of variation of RR intervals, total power, very low frequency power (VLFP), low frequency power, high frequency power (HFP), normalized VLFP (nVLFP) and low-/high-frequency power ratio in the OHT group were all significantly decreased, while the heart rate (HR) and normalized HFP (nHFP) were significantly increased, as compared with the CABG group. The decrease in HRV was more severe in the VLFP region. A smaller nVLFP and a greater nHFP were associated with a smaller mRRI and a larger HR in the OHT patients. The slope of the power law relation of HRV became positive in OHT patients, instead of negative in CABG patients. We conclude that patients after OHT have residual HRV which were characterized by severely depressed time and frequency domain HRV, increased HR and nHFP, decreased nVLFP, and positive slope of the power-law relation of HRV. The use of nHFP as the indicator of vagal modulation and the use of nVLFP as the indicator of renin-angiotensin modulation, thermoregulation and vagal withdrawal must be careful in the OHT patients. ER - TY - JOUR T1 - Heart rate variability: a review A1 - Rajendra, U A1 - Ae, Acharya A1 - Paul, K A1 - Ae, Joseph A1 - Kannathal, N A1 - Choo, A E A1 - Lim, Min A1 - Jasjit, A E A1 - Suri, S KW - ANOVA test KW - Approximate entropy KW - Autonomic nervous system KW - Correlation dimension KW - Heart rate variability KW - Hurst exponent KW - Lyapunov exponent KW - Phase space plot KW - Poincare plot KW - Recurrent plot KW - Sample entropy KW - Surrogate data KW - Wavelet transform DO - 10.1007/s11517-006-0119-0 N2 - Heart rate variability (HRV) is a reliable reflection of the many physiological factors modulating the normal rhythm of the heart. In fact, they provide a powerful means of observing the interplay between the sympathetic and parasympathetic nervous systems. It shows that the structure generating the signal is not only simply linear, but also involves nonlinear contributions. Heart rate (HR) is a nonstationary signal; its variation may contain indicators of current disease, or warnings about impending cardiac diseases. The indicators may be present at all times or may occur at random-during certain intervals of the day. It is strenuous and time consuming to study and pinpoint abnormalities in voluminous data collected over several hours. Hence, HR variation analysis (instanta-neous HR against time axis) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system. Computer based analytical tools for in-depth study of data over daylong intervals can be very useful in diagnostics. Therefore, the HRV signal parameters, extracted and analyzed using computers , are highly useful in diagnostics. In this paper, we have discussed the various applications of HRV and different linear, frequency domain, wavelet domain, nonlinear techniques used for the analysis of the HRV. ER - TY - ICOMM T1 - Trasplante de corazón | Clínica Cardio VID UR - https://www.cardiovid.org.co/index.php/trasplante-de-corazon/ ER - TY - RPRT T1 - La palpitante historia de un trasplante A1 - Clinica cardiovascular A1 - Congregación mariana Y1 - 2010/// UR - https://www.cardiovid.org.co/wp-content/uploads/2014/10/libro252.pdf ER - TY - ICOMM T1 - Trasplante de corazón y Clínica de Falla Cardiaca | Clínica Shaio UR - https://www.shaio.org/trasplante-de-corazon-y-clinica-de-falla-cardiaca ER - TY - JOUR T1 - Unexpected Interaction Between /3-Adrenergic Blockade and Heart Rate Variability Before and After Myocardial Infarction A Longitudinal Study in Dogs at High and Low Risk for Sudden Death A1 - Adamson, Philip B A1 - Huang, Ming H A1 - Vanoli, Emilio A1 - Foreman, Robert D A1 - Schwartz, Peter J A1 - Hull, Stephen S Y1 - 1994/// UR - http://ahajournals.org ER - TY - JOUR T1 - Can power spectral analysis of heart rate variability identify a high risk subgroup of congestive heart failure patients with excessive sympathetic activation? A pilot study before and after heart transplantation A1 - Mortara, Andrea A1 - Teresa, Maria A1 - Rovere, La A1 - Signorini, Maria Gabriella A1 - Pantaleo, Paolo A1 - Pinna, Gianni A1 - Martinelli, Luigi A1 - Ceconi, Claudio A1 - Cerutti, Sergio A1 - Tavazzi, Luigi A1 - Mortara, A A1 - Pantaleo, P A1 - Pinna, G A1 - Tavazzi, L Y1 - 1994/// JF - Br Heart3r VL - 71 SP - 422 EP - 430 UR - http://heart.bmj.com/ N2 - Background and objectives-Autonomic dysfunction seems to be involved in the progression and prognosis of severe congestive heart failure. Parasympa-thetic activity can still be abnormal 4-8 weeks after haemodynamic improvement by heart transplantation. To identify patients in heart failure with a more pronounced neural derangement and to analyse the changes in sympathetic and parasympathetic activity soon after heart transplantation, spectral indices of heart rate variability were assessed in 30 patients in severe heart failure and in 13 patients after heart transplantation; a group of 15 age-matched subjects served as controls. Methods and results-Heart rate variability was assessed by standard electro-cardiography (ECG) in patients in heart failure and by oesophageal ECG in patients after heart transplantation. Compared with controls, the mean RR interval and total power were reduced in heart failure. The 30 patients showed two different patterns of heart rate variability: in 14 no power was detected in the low frequency band (0.03-0.15 Hz) (LF) and total power was mainly concentrated in the high frequency band (0.15-0-45 Hz) (HF), whereas in the remaining 16 patients power in the LF band was increased and power in HF band was reduced compared with the controls. Patients with undetectable LF had a lower mean RR interval and total power (745(25) v 864(36) ms, p < 0 05; 118(16) v 902(202) ms', p < 0.001), higher concentration of plasma noradrenaline (635(75) v 329(54) pg/ml, p < 0.05), and worse clinical status and prognosis (4 deaths v no deaths at 6 month follow up) than patients with a dominant LF band. In the post-transplant patients both the mean PP interval of the remnant atrium and total power resembled results in the patients with heart failure; in 7 of the 13 post-transplant patients no power was detectable in the LF band: when both HF and LF power were present the results resembled those in the 16 patients in heart failure. Conclusions-These data suggest that in more advanced stages of congestive heart failure, power spectral analysis of heart rate variability allows identification of a subgroup of patients with higher sympathetic activation and poorer clinical status who are at major risk of adverse events. In the short term after cardiac transplantation the spectral profile of the rhythm variability of the remnant atrium was not improved, suggesting that parasympathetic withdrawal and sympathetic hyperactivity persist, despite the restoration of ventricular function. (Br Heart J7 1994;71:422-430) Heart failure in both experimental and clinical settings is associated with considerable neuro-humoral excitation, resulting in abnormal autonomic control of cardiovascular function. Increased sympathetic activity and plasma concentrations of noradrenaline.' 2 parasym-pathetic withdrawal,3-5 and impaired barore-flex gain68 have been reported. This excessive neurohumoral activation is involved in progression of heart failure and in prognosis. Analysis of heart rate variability is regarded a valid technique to assess non-invasively the sympathovagal balance of the heart. Frequency domain analysis of heart rate fluctuations identifies the relative influence of the two neural limbs that regulate heart rhythm.9-"1 When this technique was used to study patients in congestive heart failure the results did not accord, perhaps because methods and patient selection differed.45 Parasympathetic activity assessed by time domain analysis of the variability of the sinus rhythm in the remnant remained subnormal 4-8 weeks after cardiac transplantation despite restoration of normal left ventricular function.'2 There are no data on frequency domain measurements of recipient sinus rhythm variability. Such analysis might give better discrimination of the role of sympathetic activity in the recovery of autonomic function. In our present study we tested the hypothesis that power spectrum analysis of heart rate variability in congestive heart failure may identify patients with a more pronounced 422 group.bmj.com on June 9, 2015-Published by http://heart.bmj.com/ Downloaded from ER - TY - ICOMM T1 - Guía Elaboración Consentimiento Informado A1 - Organización Mundial de la Salud (OMS) UR - http://cec.ufro.cl/index.php/modelos-tipo?id=10 ER - TY - JOUR T1 - Perioperative mortality is the Achilles heel for cardiac transplantation in adults with congenital heart disease: Evidence from analysis of the UNOS registry A1 - Shah, Dipesh K. A1 - Deo, Salil V. A1 - Althouse, Andrew D. A1 - Teuteberg, Jeffery J. A1 - Park, Soon J. A1 - Kormos, Robert L. A1 - Burkhart, Harold M. A1 - Morell, Victor O. Y1 - 2016/// JF - Journal of Cardiac Surgery VL - 31 IS - 12 SP - 755 EP - 764 DO - 10.1111/jocs.12857 N2 - BACKGROUND: Adults with congenital heart disease may present with end-stage heart failure necessitating orthotopic heart transplant (OHT). We sought to review the United Network for Organ Sharing (UNOS) experience with this unique cohort focusing on surgical outcomes and survival. METHODS: From the UNOS registry, 737 adult congenital heart disease recipients (ACHDR) out of 26,993 OHT patients (2.7%) who underwent OHT were studied to analyze early and late outcomes and compared to non-congenital recipients (NCR) over a 15-year period (2000-2014). RESULTS: More ACHDR underwent OHT in the recent-era (3.1%; 2010-2014) as compared to the initial-era (2.5%; 2000-2004; p=0.03). ACHDR were more likely female (40% vs. 24%; p10%; p<0.01, and were listed for a longer time (249 vs. 181 days; p<0.01). When compared to the NCR in the same period, the ACHDR cohort had longer postoperative length of stay (27 vs. 20 days; p<0.01), higher operative mortality (11.5% vs. 4.6% p<0.001), higher incidence of primary graft dysfunction (4.3% vs. 2.6%; p<0.01), and higher need for dialysis (20% vs. 9%; p<0.01). Primary graft dysfunction is the most common cause of death in (5.8%) ACHDR. Although short-term survival is poorer, long-term survival of ACHDR was found to be equivalent or better than NCR in long term. CONCLUSIONS: Perioperative morbidity and mortality adversely affects short-term survival in ACHDR. ACHDR who survive the first post-transplant year have equivalent or better long-term survival than NCR. Copyright © 2016 Wiley Periodicals, Inc. ER - TY - JOUR T1 - Visualization of heart rate variability of long-term heart transplant patient by transition networks: A Case Report A1 - Wdowczyk, Joanna A1 - Makowiec, Danuta A1 - Dorniak, Karolina A1 - Gruchala, Marcin Y1 - 2016/// KW - Arrhythmias KW - Cardiac autonomic modulation KW - Heart rate variability KW - Heart transplantation KW - Hearth rhythm dynamics KW - Reinnervation JF - Frontiers in Physiology VL - 7 IS - MAR SP - 2012 EP - 2017 DO - 10.3389/fphys.2016.00079 N2 - We present a heart transplant patient at his 17th year of uncomplicated follow-up. Within a frame of routine check out several tests were performed. With such a long and uneventful follow-up some degree of graft reinnervation could be anticipated. However, the patient's electrocardiogram and exercise parameters seemed largely inconclusive in this regard. The exercise heart rate dynamics were suggestive of only mild, if any parasympathetic reinnervation of the graft with persisting sympathetic activation. On the other hand, traditional heart rate variability (HRV) indices were inadequately high, due to erratic rhythm resulting from interference of the persisting recipient sinus node or non-conducted atrial parasystole. New tools, originated from network representation of time series, by visualization short-term dynamical patterns, provided a method to discern HRV increase due to reinnervation from other reasons. ER - TY - JOUR T1 - Early parasympathetic reinnervation is not related to reconnection of major branches of the vagus nerve after heart transplantation A1 - Lee, So Ryoung A1 - Kang, Do Yoon A1 - Cho, Youngjin A1 - Cho, Hyun Jai A1 - Lee, Hae Young A1 - Choi, Eue Keun A1 - Oh, Seil Y1 - 2016/// KW - Heart transplantation KW - Parasympathetic KW - Reinnervation KW - Vagus nerve JF - Korean Circulation Journal VL - 46 IS - 2 SP - 197 EP - 206 DO - 10.4070/kcj.2016.46.2.197 N2 - BACKGROUND AND OBJECTIVES Bicaval heart transplantation (HTx) may promote parasympathetic reinnervation. However, the prevalence and timing of reinnervation have not been fully investigated. Heart rate variability (HRV) and direct vagal stimulation were used to evaluate the presence of parasympathetic reinnervation after bicaval HTx. SUBJECTS AND METHODS A total of 21 patients (time after HTx 0.52-4.41 years, mean 1.8±1.2 years) who received a bicaval HTx was enrolled. Reinnervation was evaluated using HRV values from 24-hour Holter recordings. A cross-sectional analysis of the HRV at 0.5-1, 1-2, and >2 years after HTx was performed. We also applied high-frequency electrical stimulation (16.7 Hz, 1 msec pulse width, ≤10 V) to the cardiac branches of the vagus nerve at the level of the superior vena cava in eight patients at 6 and 12 months after HTx. RESULTS The degree of parasympathetic reinnervation corresponded to the time after HTx. The HRV analysis revealed that the root mean square of the successive differences between consecutive RR-intervals (RMSSD) and high-frequency power were significantly higher during the late period (>2 years) compared with the early period (0.5-1 year) after HTx. None of the eight patients who underwent direct vagal stimulation responded during the stimulation at 6 and 12 months, whereas incremental trends in HRV parameters were observed, which indicated that parasympathetic reinnervation began within 1 year after HTx. CONCLUSION Parasympathetic reinnervation seemed to begin in the early period (<1 year) after bicaval HTx. Reconnection of major branches of the vagus nerve may not be related to early reinnervation. ER - TY - JOUR T1 - Parasympathetic reinnervation accompanied by improved post-exercise heart rate recovery and quality of life in heart transplant recipients. A1 - Imamura, Teruhiko A1 - Kinugawa, Koichiro A1 - Okada, Ikuko A1 - Kato, Naoko A1 - Fujino, Takeo A1 - Inaba, Toshiro A1 - Maki, Hisataka A1 - Hatano, Masaru A1 - Kinoshita, Osamu A1 - Nawata, Kan A1 - Kyo, Shunei A1 - Ono, Minoru Y1 - 2015/// KW - Adult KW - Exercise KW - Exercise Test KW - Exercise Tolerance KW - Female KW - Follow-Up Studies KW - Heart KW - Heart Failure KW - Heart Rate KW - Heart Transplantation KW - Humans KW - Male KW - Middle Aged KW - Oxygen Consumption KW - Parasympathetic Nervous System KW - Quality of Life KW - Recovery of Function KW - Surveys and Questionnaires KW - Time Factors KW - Treatment Outcome KW - Young Adult KW - innervation KW - physiology KW - physiopathology KW - surgery JF - International heart journal VL - 56 IS - 2 SP - 180 EP - 185 SN - 1349-2365 DO - 10.1536/ihj.14-292 N2 - Although sympathetic reinnervation is accompanied by the improvement of exercise tolerability during the first years after heart transplantation (HTx), little is known about parasympathetic reinnervation and its clinical impact. We enrolled 21 recipients (40 +/- 16 years, 71% male) who had received successive cardiopulmonary exercise testing at 6 months, and 1 and 2 years after HTx. Exercise parameters such as peak oxygen consumption or achieved maximum load remained unchanged, whereas recovery parameters including heart rate (HR) recovery during 2 minutes and the delay of peak HR, which are influenced by parasympathetic activity, improved significantly during post-HTx 2 years (P < 0.05 for both). HR variability was analysed at post-HTx 6 months in 18 recipients, and high frequency power, representing parasympathetic activity, was significantly associated with the 2 recovery parameters (P < 0.05 for all). We also assessed quality of life using the Minnesota Living with Heart Failure (HF) Questionnaire at post-HTx 6 months and 2 years in the same 18 recipients, and those with improved recovery parameters enjoyed a better HF-specific quality of life (P < 0.05 for both). In conclusion, parasympathetic reinnervation emerges along with improved post-exercise recovery ability of HR and quality of life during post-HTx 2 years. ER - TY - JOUR T1 - Evidence for differential sympathetic and parasympathetic reinnervation after heart transplantation in humans A1 - Tio, René A. A1 - Reyners, An K.L. A1 - Van Veldhuisen, Dirk J. A1 - Van den Berg, Maarten P. A1 - Brouwer, René M.H.J. A1 - Haaksma, Jaap A1 - Smit, Andries J. A1 - Crijns, Harry J.G.M. Y1 - 1997/// KW - Autonomic testing KW - Heart rate variability KW - Heart transplantation KW - Human KW - Reinnervation JF - Journal of the Autonomic Nervous System VL - 67 IS - 3 SP - 176 EP - 183 SN - 0165-1838 DO - 10.1016/S0165-1838(97)00104-5 N2 - During heart transplantation (HTX) all neural connections are severed. In humans, signs of autonomic reinnervation have been found. In this study non-invasive tests were used to compare signs of sympathetic and parasympathetic reinnervation. Non-invasive autonomic function tests and heart rate variability parameters (HRV; 24 h electrocardiographic registration) were used to investigate signs of reinnervation. 16 HTX patients (14 males) were compared with age- and sex-matched controls. Parasympathetic heart rate changes in HTX compared to controls were attenuated during the diving test, deep breathing, the Valsalva maneuver and standing up but not during carotid sinus massage. Sympathetic heart rate increases were lower during the cold presser test and mental stress. The blood pressure responses were comparable to the control group, but not during active standing and tilting. This finding suggests an obligatory 'blood pressure' role for the innervated heart in these two tests. All HRV parameters were lower in HTX. One or more normal parasympathetic responses were found in 13 out of 16 patients versus 4 out of 16 with normal sympathetic responses (p < 0.05). Heart rate variations were less in case of a higher donor age, and higher in case of a longer time after HTX. Parasympathetic signs of reinnervation are more common than sympathetic signs of reinnervation. A higher donor age reduces signs of reinnervation. If the sympatho-vagal balance is a prognostic factor in HTX patients as it is in other cardiac diseases these findings are clinically relevant. ER - TY - ICOMM T1 - Donación y trasplantes de órganos UR - https://www.minsalud.gov.co/salud/MT/Paginas/donacion-y-trasplantes-de-organos.aspx ER - TY - JOUR T1 - Absence of Parasympathetic Control of Heart Rate After Human Orthotopic Cardiac Transplantation A1 - Arrowood, James A. A1 - Minisi, Anthony J. A1 - Goudreau, Evelyne A1 - Davis, Annette B. A1 - King, Anne L. Y1 - 1997/11// KW - autonomic KW - heart rate KW - nervous system, autonomic KW - reflex KW - transplantation KW - vagus nerve PB - Lippincott Williams & Wilkins JF - Circulation VL - 96 IS - 10 SP - 3492 EP - 3498 DO - 10.1161/01.CIR.96.10.3492 UR - https://www.ahajournals.org/doi/abs/10.1161/01.cir.96.10.3492 N2 - Background Partial reinnervation of cardiac sympathetic nerves has been observed after heart transplantation; we hypothesized that parasympathetic control to the heart after transplantation may ret... ER - TY - JOUR T1 - Long-Term Assessment of Heart Rate Variability in Cardiac Transplant Recipients A1 - Keeley, Ellen C A1 - Toth, Zoltan K A1 - Goldberg, A David A1 - Wiener, Michael A Y1 - 2000/// JF - J Heart Lung Transplant VL - 19 SP - 310 EP - 312 N2 - Sympathetic and parasympathetic reinnervation of the transplanted heart were evaluated by assessing time and frequency domain measurements of heart rate variability at 5 and 8 years. Continuous 24-hour ECG measurements were performed in 13 patients (57 6 months and 90 7 months) after orthotopic cardiac transplantation and in 22 healthy age and gender-matched controls, and were analyzed for heart rate variability in the time and frequency domains. Heart rate variability measures reflective of sympathetic reinnervation were sub-normal at 5 years and unchanged at 8 years: those reflective of parasympathetic reinnervation were absent. Heart rate variability (HRV), the measurement of the beat-to-beat variation in heart rate provides a non-invasive means to quantify the influence of the autonomic nervous system on the heart. Spectral analysis of HRV allows distinction between frequencies related to respiration and vagal activity (high frequency), and those related mainly to sympathetic activity (low frequency). The balance between the sympathetic and parasympathetic influence on cardiac function, as measured by HRV, has been shown to be abnormal in patients after heart transplanta-tion. 1 Cardiac transplantation results in complete de-nervation of the donor heart. As a result of dener-vation, HRV is undetectable early after heart trans-plantation. 1-2 Whereas in canine models, both sympathetic and parasympathetic reinnervation occur within 6 months after heart transplantation, 3-4 studies of human cardiac transplantation recipients have yielded conflicting results. 5-9 In the present study, we hypothesized that 1) the sympathetic influence on the heart continues to increase beyond 3 years after heart transplantation, approaching normal levels; and 2) the transplanted heart becomes innervated by the parasympathetic nervous system beyond 3 years after transplantation. To test these hypotheses, the sympathetic and para-sympathetic influence on the transplanted heart were evaluated by obtaining time and frequency domain measurements of HRV in each of 13 patients 5 and 8 years after heart transplantation. METHODS The study group consisted of 13 patients who underwent orthotopic cardiac transplantation. Each patient underwent 24-hour continuous ECG monitoring for HRV analysis at 57 6 months and again 90 7 months after heart transplantation. Average age of the patients was 46 7 years. In addition to immunosuppressive medications, all were taking angiotensin-converting enzyme inhibitors and calcium channel blockers. None received a beta-agonist, beta-antagonist, clonidine or anti-arrhyth-From the Henry Ford Heart and Vascular Institute, ER - TY - JOUR T1 - Sympathetic reinnervation 1 year after heart transplantation, assessed using iodine-123 metaiodobenzylguanidine imaging. A1 - F, Buendia-Fuentes A1 - L, Almenar A1 - C, Ruiz A1 - JL, Vercher A1 - I, Sánchez-Lázaro A1 - L, Martínez-Dolz A1 - J, Navarro A1 - P, Bello A1 - A, Salvador Y1 - 2011/07// KW - Europe PMC KW - Europe PubMed Central KW - ORCIDs KW - REST APIs KW - abstracts KW - bioinformatics KW - biological patents KW - biomedical journals KW - biomedical research KW - citation networks KW - citation search KW - clinical guidelines KW - full text KW - journal articles KW - life sciences KW - literature search KW - open access KW - research articles KW - text mining JF - Transplantation Proceedings VL - 43 IS - 6 SP - 2247 EP - 2248 DO - 10.1016/J.TRANSPROCEED.2011.05.020 UR - https://europepmc.org/article/med/21839246 N2 - Complete allograft denervation occurs during heart transplantation (HT). Partial ventricular sympathetic reinnervation that may develop after transplantation can be measured using iodine-123 meta iodobenzylguanidine (MIBG) uptake. Previous studies have suggested that reinnervation is likely to be a slow process, only occurring after 1 year posttransplantation. However, the reinnervation prevalence at 1 year after HT remains unknown. This study sought to determine sympathetic reinnervation measured by MIBG at 12 months after surgery. We performed serial cardiac MIBG imaging in 45 cardiac transplant recipients, including 32 males and 13 females, early (2 months) and late (12 months) after the operation. The intensity of myocardial MIBG uptaken was quantified by heart-to-mediastinum ratios (HMR). Reinnervation was considered when the HMR was >1.3. HMR was significantly higher at 12 months: 1.16 ± 0.10 at 2 vs 1.30 ± 0.15 at 12 months (P <.001). Eighteen (40%) of 45 subjects developed visible cardiac MIBG uptake at 1 year after transplantation with HMR >1.3. In conclusion, partial sympathetic reinnervation increases with time after HT; it was seen in 40% of patients at 1 year after the operation. © 2011 by Elsevier Inc. All rights reserved. ER - TY - JOUR T1 - RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction A1 - Bigger, J. Thomas A1 - Fleiss, Joseph L. A1 - Steinman, Richard C. A1 - Rolnitzky, Linda M. A1 - Schneider, William J. A1 - Stein, Phyllis K. Y1 - 1995/04// KW - aging KW - electrocardiography KW - heart rate KW - nervous system KW - sinoatrial node KW - spectrum analysis PB - Lippincott Williams and Wilkins JF - Circulation VL - 91 IS - 7 SP - 1936 EP - 1943 DO - 10.1161/01.CIR.91.7.1936 N2 - Background: The purpose of this investigation was to establish normal values of RR variability for middle-aged persons and compare them with values found in patients early and late after myocardial infarction. We hypothesized that presence or absence of coronary heart disease, age, and sex (in this order of importance) are all correlated with RR variability. Methods and Results: To determine normal values for RR variability in middle-aged persons, we recruited a sample of 274 healthy persons 40 to 69 years old. To determine the effect of acute myocardial infarction RR variability, we compared measurements of RR variability made 2 weeks after myocardial infarction (n=684) with measurements made on age- and sex-matched middle- aged subjects with no history of cardiovascular disease (n=274). To determine the extent of recovery of RR variability after myocardial infarction, we compared measurements of RR variability made in the group of healthy middle- aged persons with measurements made in 278 patients studied 1 year after myocardial infarction. We performed power spectral analyses on continuous 24- hour ECG recordings to quantify total power, ultralow-frequency (ULF) power, very-low-frequency (VLF) power, low-frequency (LF) power, high-frequency (HF) power, and the ratio of LF to HF (LF/HF) power. Time-domain measures also were calculated. All measures of RR variability were significantly and substantially lower in patients with chronic or subacute coronary heart disease than in healthy subjects. The difference from normal values was much greater 2 weeks after myocardial infarction than 1 year after infarction, but the fractional distribution of total power into its four component bands was similar for the three groups. In healthy subjects, ULF power did not change significantly with age; VLF, LF, and HF power decreased significantly as age increased. Patients with chronic coronary heart disease showed little relation between power spectral measures of RR variability and age. Patients with a recent myocardial infarction showed a strong inverse relation between VLF, LF, and HF power and age and a weak inverse relation between ULF power and age. ULF power best separates the healthy group from either of the two coronary heart disease groups. Differences in RR variability between men and women were small and inconsistent among the three groups. Conclusions: All measures of RR variability were significantly and substantially higher in healthy subjects than in patients with chronic or subacute coronary heart disease. The difference between healthy middle-aged persons and those with coronary heart disease was much greater 2 weeks after myocardial infarction than 1 year after infarction, but the fractional distribution of total power into its four component bands was similar for the healthy group and the two coronary heart disease groups. Values of RR variability previously reported to predict death in patients with known chronic coronary heart disease are rarely (≃1%) found in healthy middle-aged individuals. Thus, when measures of RR variability are used to screen groups of middle-aged persons to identify individuals who have substantial risk of coronary deaths or arrhythmic events, misclassification of healthy middle-aged persons should be rare. ER - TY - JOUR T1 - No Title A1 - Ewing, D J A1 - Borsey, D Q A1 - Bellavere, F A1 - Clarke, B F A1 - DJ, Ewing A1 - DQ, Borsey A1 - F, Bellavere A1 - BF, Clarke Y1 - 1981/07// KW - Adult KW - Aged KW - B F Clarke KW - Computers KW - D J Ewing KW - D Q Borsey KW - Diabetes mellitus KW - Diabetic Neuropathies / physiopathology* KW - Female KW - Heart / innervation* KW - Heart / physiopathology KW - Heart Rate* KW - Humans KW - MEDLINE KW - Male KW - Middle Aged KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Non-U.S. Gov't KW - PubMed Abstract KW - R-R interval variation KW - Research Support KW - Respiration KW - autonomic neuro-pathy KW - doi:10.1007/BF03216217 KW - pmid:7274613 KW - tests of autonomic function PB - Diabetologia JF - Diabetologia VL - 21 IS - 1 SP - 18 EP - 24 DO - 10.1007/BF03216217 UR - https://pubmed.ncbi.nlm.nih.gov/7274613/ ER - TY - JOUR T1 - Mortalidad precoz en trasplante cardíaco A1 - Juan Esteban Gómeza,∗, Noel Flóreza, Pastor Olayaa, Stephany Jaramillob, Julián Chicab, Martín Ramosa, Erika Rincóna y Diana Cristina Carrillo Y1 - 2017/// KW - Cardiac transplant KW - Mortality KW - Trasplant JF - Revista colombiana de cardiologia VL - 24 IS - 5 SP - 442 EP - 447 N2 - Objetivo: describir las principales causas de mortalidad en los 30 primeros días postrasplante cardíaco. Métodos: cohorte retrospectiva de pacientes con trasplante cardiaco realizado de 2008 a 2015, que murieron en los primeros 30 días luego del procedimiento. La información se recolectó del registro institucional de trasplante cardíaco. Se describieron variables sociodemográficas, clínicas, características del receptor, causas de muerte, complicaciones y características del pre- intra- y postoperatorio. Resultados: desde enero de 2008 hasta agosto de 2015 se realizaron 74 trasplantes cardíacos. De estos, 10 pacientes murieron en los primeros 30 días postrasplante (mortalidad de 13,51%). La mediana de edad fue 55 a˜ nos (rango intercuartil [RIQ] 26-62 a˜ nos) y 50% de ellos fueron de sexo masculino. La mediana de fracción de eyección pretrasplante fue 24% (RIQ 18-47) y el tiempo en lista de espera 81 días (RIQ 12-157 días). Cuatro pacientes se encontraban en estadio 0 A y los seis restantes en estadio 1. La mediana de tiempo entre el trasplante y la muerte fue un día (RIQ 0-3 día) y la mortalidad más tardía se presentó a los 18 días. Las principales causas de muerte fueron: falla multiorgánica (5 casos), falla aguda del injerto (3 casos) y coagulopatía perioperatoria (2 casos). Conclusiones: en una institución de referencia para trasplante cardíaco del suroccidente colom- biano, la mortalidad precoz postrasplante cardíaco fue del 13,51%, similar a la reportada por registros internacionales. La principal causa de muerte fue la falla multiorgánica, que ocurrió principalmente en las primeras 24 horas después del trasplante cardíaco ER -