Occurrence of neuropathies in patients with severe heart failure before and after heart transplantation

Neurol Sci. 2016 Mar;37(3):393-401. doi: 10.1007/s10072-015-2413-9. Epub 2015 Nov 14.

Abstract

Neuropathies may affect heart reinnervation and functional outcome after heart transplantation (HT). In this study, neurological evaluations, standard nerve conduction studies, and electromyography were performed in 32 HT candidates without a previous history of neuromuscular disorder. Ten patients underwent HT and were revaluated 3 months later. We found that before HT 10 (31.3%) patients had sensorimotor polyneuropathy (18.8%) or sensory polyneuropathy (12.5%). After HT, the percentage of patients with a neuromuscular disorder increased to 70%, most of them showing new or worsening neuropathies or neuromyopathies. The most sensitive abnormality that indicated neuromuscular involvement after HT was a reduction of the compound muscle action potential (CMAP) of the deep peroneal nerve. In conclusion, neuromuscular disorders are common in HT candidates, and they further increase in occurrence after HT. A reduction of the deep peroneal nerve CMAP amplitude after HT may help to identify patients who need a more detailed neurophysiological evaluation. The diagnosis of neuromuscular disorders before and after HT may contribute to the development of more accurate therapeutic and rehabilitative strategies for these patients.

Keywords: EMG; Heart transplant candidates; Heart transplant recipients; Nerve conduction studies; Neuromuscular disorders.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Electromyography
  • Female
  • Heart Failure / epidemiology*
  • Heart Failure / physiopathology
  • Heart Failure / surgery*
  • Heart Transplantation* / adverse effects
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction
  • Neuromuscular Diseases / diagnosis
  • Neuromuscular Diseases / epidemiology*
  • Neuromuscular Diseases / physiopathology
  • Peroneal Nerve / physiopathology
  • Recovery of Function
  • Sural Nerve / physiopathology
  • Treatment Outcome
  • Ulnar Nerve / physiopathology