Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality. J Card Fail 2019 Apr;25(4):249-256
Date
01/28/2019Pubmed ID
30685400DOI
10.1016/j.cardfail.2019.01.009Scopus ID
2-s2.0-85062353718 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
BACKGROUND: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes.
METHODS AND RESULTS: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41%) and HR <95 beats/min (n = 232; 59%). Median follow-up time was 6.6 (interquartile range [IQR] 2.2-7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E' higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality.
CONCLUSIONS: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.
Author List
Liebo M, Newman J, Joshi A, Lowes BD, Peled-Potashnik Y, Basha HI, Zolty R, Um JY, McGee E Jr, Heroux A, Raichlin EAuthor
Eugenia Raichlin MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAllografts
Echocardiography
Female
Follow-Up Studies
Graft Rejection
Heart Failure
Heart Rate
Heart Transplantation
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
United States
