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Peter A. Shapiro, MD; Richard P. Sloan, PhD; Evelyn M. Horn, MD; Michael M. Myers, PhD; Jack M. Gorman, MD

Arch Gen Psychiatry. 1993;50(4):275-279.

Abstract
• Heart transplant recipients provide a useful model for study of the autonomic control of the cardiovascular response to mental stress. Utilizing the innervated native atrial tissue of heart transplant recipients as an internal control exposed to the same circulatory milieu as the denervated graft heart was exposed to, the effect of innervation on the heart rate response to a mentally stressful arithmetic task was examined in eight subjects. Compared with the graft, the innervated atrial tissue manifested a larger heart rate increase during the task, larger heart rate decrease after the task, and more rapid rate of change in heart rate during the task and recovery periods. Thus, cardiac denervation results in a chronotropic response to mental arithmetic-induced stress that is blunted and more gradual than that of the innervated heart but not completely eliminated. The cardiac chronotropic response to mental arithmetic stress is dependent on both humoral factors and, predominantly, its direct autonomic innervation.

Author Affiliations
From the Departments of Psychiatry (Drs Shapiro, Sloan, Myers, and Gorman) and Medicine (Dr Horn), College of Physicians and Surgeons, Columbia University; the Departments of Clinical Psychobiology (Drs Shapiro, Sloan, and Gorman) and Developmental Psychobiology (Drs Sloan and Myers), New York State Psychiatric Institute; the ConsultationLiaison Psychiatry Service, Presbyterian Hospital (Dr Shapiro); and the Behavioral Medicine Program, Columbia-Presbyterian Medical Center (Dr Sloan), New York, NY. Dr Shapiro is the recipient of an Irving Assistant Professorship. Dr Horn is a Physician-Scientist of the American College of Chest Physicians.

Footnotes
Accepted for publication April 7, 1992.

Presented in part at the Annual Meeting of the American Psychosomatic Society, Boston, Mass, March 23, 1990.

Reprint requests to Presbyterian Hospital, Box 427, 622 W 168 St, New York, NY 10032 (Dr Shapiro).

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