EFFECT OF POSTURAL CHANGE IN HEART TRANSPLANT PATIENTS

原位心脏移植的后果是永久性的去神经。 捐赠者的心脏。这项拟议研究的具体目的是 立位改变对原位心脏血管稳定性的影响 移植受者“是比较心输出量(CO)、中风 容量(SV)、平均动脉压(MAP)、心率(HR)、全身 心脏血管阻力(SVR)和去甲肾上腺素(NE)水平 在移植受者和正常受试者中，当两者都受到 倾斜台试验。长期目标包括确定如何 当自主神经功能受到干扰时，生理反应会发生改变 心脏去神经。使用两组准实验前测- 后测设计，心脏移植受者和年龄和性别匹配 正常控制将受到被动倾斜，从水平倾斜到70 通过电动倾斜台的角度。移植的排除标准 主题包括：心脏或肾功能衰竭的证据，液体滞留， 头晕、晕厥或直立性低血压。排除标准： 控制对象包括：直立性低血压、晕厥、心悸 或心脏或内分泌功能障碍的任何其他表现。重复 之前将测量CO、SV、MAP、HR、SVR和NE水平， 在被动倾斜期间和之后。将使用Repeat分析数据 测量多变量方差分析。了解生理学原理 当自主神经功能被扰乱时，反应被改变将增强 护士提供有效护理和促进独立性的能力 心脏移植受者的活动情况。

A consequence of orthotopic heart transplantation is permanent denervation of the donor heart. The specific aim of the proposed study, "The Effect of Orthostatic Change on Cardiovascular Stability in Orthotopic Heart Transplant Recipients" is to compare changes in cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), heart rate (HR), systemic vascular resistance (SVR), and norepinephrine (NE) levels in heart transplant recipients and in normal subjects when both are subjected to a tilt table test. The long-term objectives include determining how physiologic responses are altered when autonomic function is disrupted by cardiac denervation. Using a two-group, quasi-experimental pretest- posttest design, heart transplant recipients and age- and sex-matched normal controls will be subjected to passive tilt from horizontal to 70 degrees via a motorized tilt table. Exclusion criteria for transplant subjects include: evidence of cardiac or renal failure, fluid retention, dizziness, syncope, or orthostatic hypotension. Exclusion criteria for control subjects include: orthostatic hypotension, syncope, palpitations or any other manifestation of cardiac or endocrine dysfunction. Repeated measures of CO, SV, MAP, HR, SVR, and NE levels will be taken before, during, and after passive tilt. Data will be analyzed using repeated measures multivariate analysis of variance. Understanding how physiologic responses are altered when autonomic function is disrupted will enhance nurses' abilities to provide effective care and to promote independent activity among heart transplant recipients.