The proposed study aims to establish the relative contribution of central nervous system autonomic innervation of the heart to, and the effect of denervation on, the cardiovascular response to psychological stressors, and to examine the relationship of psychophysiological reactivity to the development of cardiovascular disease in heart transplant recipients. Twenty cardiac transplant recipients will be compared to matched heart surgery (innervated) control subjects and two groups of normal control subjects: 1) matched for age of the transplant patient and 2) matched for the age of the donor heart. Heart rate, systolic and diastolic blood pressure, cardiac output, and circulating epinephrine and norepinephrine responses to two standardized psychological stressors, mental arithmetic (MA) and a reaction time task (RT), will be evaluated. Cardiac output will be measured non-invasively by impedance cardiography. Power spectral analysis of heart rate variability will be used to determine the contribution of sympathetic and parasympathetic nervous system activity during psychological stress-testing. Subjects will be tested at three, six and twelve months after surgery (and at corresponding intervals for normal controls; normals matched for the age of the donor heart will be tested only at the three month interval) to test the hypotheses that: 1. a. Intact autonomic innervation is necessary for the full cardiovascular response to mental stress. b. Detectable reactivity will occur in denervated heart subjects, predominantly due to circulating catecholamines. Vagal effects will be absent. 2. Following denervation, the hemodynamic response to increases in catecholamines will change over time, reflecting adaptation. 3. High hemodynamic reactivity, within the cardiac transplant recipients, will be associated with increased subsequent cardiovascular disease (development of graft coronary artery disease).

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH043977-03
Application #
3383442
Study Section
Psychopathology and Clinical Biology Research Review Committee (PCB)
Project Start
1990-09-01
Project End
1993-08-31
Budget Start
1992-09-30
Budget End
1993-08-31
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Columbia University (N.Y.)
Department
Type
Schools of Medicine
DUNS #
064931884
City
New York
State
NY
Country
United States
Zip Code
10027
Norton, Michele R; Sloan, Richard P; Bagiella, Emilia (2005) New approach to the statistical analysis of cardiovascular data. J Appl Physiol 98:2298-303
McKinley, Paula S; Shapiro, Peter A; Bagiella, Emilia et al. (2003) Deriving heart period variability from blood pressure waveforms. J Appl Physiol 95:1431-8
Bagiella, E; Sloan, R P; Heitjan, D F (2000) Mixed-effects models in psychophysiology. Psychophysiology 37:13-20
Sloan, R P; Shapiro, P A; Bagiella, E et al. (1999) Cardiac autonomic control buffers blood pressure variability responses to challenge: a psychophysiologic model of coronary artery disease. Psychosom Med 61:58-68
Sloan, R P; Shapiro, P A; Bagiella, E et al. (1996) Relationships between circulating catecholamines and low frequency heart period variability as indices of cardiac sympathetic activity during mental stress. Psychosom Med 58:25-31
Shapiro, P A; Sloan, R P; Bagiella, E et al. (1996) Heart rate reactivity and heart period variability throughout the first year after heart transplantation. Psychophysiology 33:54-62
Sloan, R P; Shapiro, P A; Bagiella, E et al. (1995) Temporal stability of heart period variability during a resting baseline and in response to psychological challenge. Psychophysiology 32:191-6
Shapiro, P A; Sloan, R P; Bigger Jr, J T et al. (1994) Cardiac denervation and cardiovascular reactivity to psychological stress. Am J Psychiatry 151:1140-7
Sloan, R P; Shapiro, P A; Bagiella, E et al. (1994) Brief interval heart period variability by different methods of analysis correlates highly with 24 h analyses in normals. Biol Psychol 38:133-42
Sloan, R P; Shapiro, P A; Bagiella, E et al. (1994) Effect of mental stress throughout the day on cardiac autonomic control. Biol Psychol 37:89-99

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