Altered cardiovascular and neurohumoral responses to head-up tilt after heart-lung transplantation

Heart-lung transplantation results in afferent and efferent denervation of the transplanted organs including interruption of the central connections from the low-pressure receptors in the atria and pulmonary veins. We investigated whether the cardiovascular and neurohumoral responses to the postural stimulus of head-up tilt were affected after transplantation. Responses in eight heart-lung transplant recipients were studied and compared with those in eight normal subjects matched for age and sex during passive head-up tilt at 45 degrees for 1 hour. The transplant group had a higher initial heart rate (99 +/- 2 versus 68 +/- 2 beats/min, p less than 0.001) and diastolic blood pressure (88 +/- 5 versus 76 +/- 2 mm Hg, p less than 0.05) than did the control group. The increases in heart rate and diastolic blood pressure during head-up tilt were similar in the two groups. Systolic blood pressure remained unchanged. The decrease in cardiac output (30% versus 18%, p less than 0.05) and the increase in systemic ...