The 24-hour rhythm of blood pressure differs from that of leg hemodynamics in orthotopic heart transplant recipients

Background This study was aimed at investigating whether a circadian rhythm of peripheral resistance exists in patients with orthotopic cardiac transplantation (OCT) and whether it parallels that of blood pressure (BP). Methods BP and leg flow and resistance (plethysmography) were monitored for 24 h...

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Published in:The American heart journal 2000-12, Vol.140 (6), p.941-944
Main Authors: Casiglia, Edoardo, Pizziol, Alessandra, Tikhonoff, Valérie, Mazza, Alberto, Di Menza, Giuseppe, Palatini, Paolo, Gambino, Antonio, Cerutti, Alessia, Pessina, Achille C., Casarotto, Dino
Format: Article
Language:English
Subjects:
Adult
Autonomic Nervous System - physiology
Biological and medical sciences
Blood Flow Velocity - physiology
Blood Pressure - physiology
Blood Pressure Monitoring, Ambulatory
Cardiovascular system
Circadian Rhythm - physiology
Heart Transplantation - physiology
Humans
Investigative techniques of hemodynamics
Investigative techniques, diagnostic techniques (general aspects)
Leg - blood supply
Male
Medical sciences
Middle Aged
Plethysmography
Prognosis
Vascular Resistance - physiology
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Summary:Background This study was aimed at investigating whether a circadian rhythm of peripheral resistance exists in patients with orthotopic cardiac transplantation (OCT) and whether it parallels that of blood pressure (BP). Methods BP and leg flow and resistance (plethysmography) were monitored for 24 hours in 13 denervated OCT recipients and 13 control patients with native heart, matched for casual blood pressure. Results On the basis of BP trend, control patients showed a BP reduction during sleep, whereas OCT recipients did not. Leg resistance was significantly lower and leg flow significantly higher during sleep than during waking in all patients, and the extent of the nocturnal decrease was similar in the two categories. Conclusions The decrease in leg resistance in patients confined to bed for 24 hours is caused by peripheral mechanisms and does not depend on the autonomic control of the heart. The nocturnal decline in BP depends, on the contrary, on cardiac control and is lost in patients with denervated heart. (Am Heart J 2000;140:941-4.)
ISSN:0002-8703
1097-6744
DOI:10.1067/mhj.2000.111110