BACKGROUND: Elevated heart rate (HR) is associated with adverse cardiovascular outcome in the general population and in patients with cardiovascular disease. Elevated HR due to graft denervation is often found in heart transplantation (HTx) patients; the effect on graft survival and vasculopathy is unclear. Thus, the aim of this study was to evaluate the role of elevated HR at 12 months post-HTx and its power to predict HTx long-term outcome. METHODS: We evaluated retrospectively a prospective database of 312 patients undergoing HTx at two centers. HR was registered at 12 months post-HTx. The median HR was used as a cutoff point. Cox regression analysis was performed with variables known to be clinically relevant to mortality and those selected from the univariate analysis. RESULTS: During a mean follow-up of 5.5 ± 2.8 years there were 58 deaths (19%). Patients with a HR ≥ 90 bpm (median HR) at 12 months had an increased risk for all-cause mortality (Hazard Ratio=2.4, 95% CI 1.2 to 4.5, p=0.009) and mortality related to coronary allograft vasculopathy (CAV) (Hazard Ratio=3.0, 95% CI 1.25-7.14, p=0.01). Multivariate analysis showed that a HR ≥ 90 bpm independently predicted mortality (HR 3.2, 95% CI 1.4-7.1, p=0.004). CONCLUSIONS: Elevated HR measured at 12 months after HTx is an independent predictor of all-cause mortality in HTx recipients. A HR ≥ 90 bpm identifies a group of patients at high risk of death and CAV-related mortality at mid- to long-term.
BACKGROUND: Elevated heart rate (HR) is associated with adverse cardiovascular outcome in the general population and in patients with cardiovascular disease. Elevated HR due to graft denervation is often found in heart transplantation (HTx) patients; the effect on graft survival and vasculopathy is unclear. Thus, the aim of this study was to evaluate the role of elevated HR at 12 months post-HTx and its power to predict HTx long-term outcome. METHODS: We evaluated retrospectively a prospective database of 312 patients undergoing HTx at two centers. HR was registered at 12 months post-HTx. The median HR was used as a cutoff point. Cox regression analysis was performed with variables known to be clinically relevant to mortality and those selected from the univariate analysis. RESULTS: During a mean follow-up of 5.5 ± 2.8 years there were 58 deaths (19%). Patients with a HR ≥ 90 bpm (median HR) at 12 months had an increased risk for all-cause mortality (Hazard Ratio=2.4, 95% CI 1.2 to 4.5, p=0.009) and mortality related to coronary allograft vasculopathy (CAV) (Hazard Ratio=3.0, 95% CI 1.25-7.14, p=0.01). Multivariate analysis showed that a HR ≥ 90 bpm independently predicted mortality (HR 3.2, 95% CI 1.4-7.1, p=0.004). CONCLUSIONS:Elevated HR measured at 12 months after HTx is an independent predictor of all-cause mortality in HTx recipients. A HR ≥ 90 bpm identifies a group of patients at high risk of death and CAV-related mortality at mid- to long-term.
Authors: Michal Pazdernik; Dan Wichterle; Zhi Chen; Helena Bedanova; Josef Kautzner; Vojtech Melenovsky; Vladimir Karmazin; Ivan Malek; Peter Stiavnicky; Ales Tomasek; Eva Ozabalova; Jan Krejci; Andreas Wahle; Honghai Zhang; Tomas Kovarnik; Milan Sonka Journal: Clin Transplant Date: 2020-01-09 Impact factor: 2.863
Authors: Morcos Awad; Lawrence S C Czer; Margaret Hou; Sarah S Golshani; Michael Goltche; Michele De Robertis; Michelle Kittleson; Jignesh Patel; Babak Azarbal; Evan Kransdorf; Fardad Esmailian; Alfredo Trento; Jon A Kobashigawa Journal: J Am Heart Assoc Date: 2016-11-01 Impact factor: 5.501
Authors: Oliver Schumacher; Lukas D Trachsel; David Herzig; Paul Mohacsi; Vilborg Sigurdardottir; Matthias Wilhelm; Prisca Eser Journal: ESC Heart Fail Date: 2021-01-08
Authors: Qi-Fang Huang; Jan Van Keer; Zhen-Yu Zhang; Sander Trenson; Esther Nkuipou-Kenfack; Lucas N L Van Aelst; Wen-Yi Yang; Lutgarde Thijs; Fang-Fei Wei; Agnieszka Ciarka; Johan Vanhaecke; Stefan Janssens; Johan Van Cleemput; Harald Mischak; Jan A Staessen Journal: PLoS One Date: 2018-09-24 Impact factor: 3.240