Elevated resting heart rate in heart transplant recipients: innocent bystander or adverse prognostic indicator?

Abstract

Heart transplant recipients with elevated resting HR appear to have higher mortality than those with lower resting HR. Whether pharmacologically lowering the HR would result in better outcomes warrants further investigation.

Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis

“…Despite its detrimental effect on the exercise capacity of HTx patients, beta‐blocker treatment might be of benefit. Compared to other studies, a relatively high proportion of patients in our cohort were prescribed beta blockers (51.7% at M1, 66.4% at M12). There are three possible explanations for this: (a) Assumption that increased HR predicts worse outcomes in cardiovascular disease could be associated with over‐prescription of beta blockers to achieve resting HR <95‐100/min; (b) favoured beta blockers for the treatment of symptomatic atrial ectopy which can be indirectly suggested by higher frequency of atrial premature complexes on 24‐hour ECG Holter observed at 1 month in patients treated with beta blockers; (c) preference of beta blockers in combination treatment of arterial hypertension.…”

“…Current data on the effects of increased resting HR on all‐cause mortality in HTx patients and CAV development are contradictory. While there is relatively uniform evidence of tachycardia‐related effects on mortality, the impact on CAV development is less clear . Due to small sample sizes, retrospective and observational approaches, and overall design, previous studieshave failed to produce convincing data on the role of tachycardia in CAV development.…”