HEART RATE VARIABILITY IN HEART TRANSPLANTATION.
Contributors: Rush University, College Of Nursing.
Published: 1987
Number of pages: 95
Subjects: Health Sciences, Nursing.
Description: Some evidence has suggested that graft rejection in heart transplant recipients is accompanied by sinus node dysfunction. To test this hypothesis, the electrocardiograms of 21 orthotropic heart transplant recipients receiving cyclosporine were recorded at regularly scheduled biopsies. This resulted in 105 good quality recordings of at least 10 minutes each. All exhibited regular sinus rhythm.

These recordings were then processed through patented digital routines which calculated the power spectrum of the RR intervals. All exhibited Mayer wave and respiratory sinus arrhythmia (RSA) periodicities. Peak spectral power of RSA (PSP-RSA) demonstrated good repeatability at two weeks (r =.81).

A paired t -test comparing the baseline PSP-RSA in nine subjects who experienced rejection episodes with their individual average PSP-RSA during periods of rejection revealed a significant decrease (p =.015). As a global measure, PSP-RSA $>$ 1 (in natural logarithmic scales) demonstrated a sensitivity of 1.0, specificity of.46, positive predictive value of.33, and negative predictive value of 1.0.

Analysis of factors which could improve sensitivity included: (a) using the P wave for interval timing; (b) taking smaller time sampling windows; and (c) controlling breathing frequency.

This study demonstrates that PSP-RSA may be a sensitive, non-invasive marker for graft rejection of cardiac transplant patients receiving cyclosporine for immunosuppression. A larger, more extensive study needs to be conducted to confirm these tentative results.
Notes: Source: Dissertation Abstracts International, Volume: 48-09, Section: B, page: 2608.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1987.

School code: 0591.