In a heart transplant patient, what is the expected change in heart rate when responding to hypotension?

In heart transplant patients, the autonomic nervous system (ANS) innervation to the heart is altered because the heart is denervated during the transplant process. They typically do not respond to autonomic cues in the same way that a normal heart would. When faced with hypotension, the body usually reacts by increasing heart rate through sympathetic stimulation to enhance cardiac output and restore blood pressure. However, in a heart transplant patient, this autonomic response is blunted since the vagus nerve and sympathetic control to the heart are disrupted.

As a result, when hypotension occurs, these patients do not exhibit the expected increase in heart rate; instead, there is often no change in heart rate, or it may respond in a very limited manner due to the lack of autonomic control. This absence of responsiveness is fundamental to understanding the physiological adjustments in heart transplant recipients. Therefore, the expected response to hypotension in these patients is a lack of change in heart rate.