Hypertension After Heart Transplantation: Predictive Factors and Number and Classes of Drugs for Its Management

Lázaro, Ignacio J. Sánchez; Bonet, Luis Almenar; Martínez‐Dolz, Luis; López, J. Moro; Ramón-Llin, Jaime Agüero; Pérez, Óscar Cano; Soriano, Joaquín Rueda; Fuentes, Francisco Buendía; Manchón, Josep Navarro; Montoro, Juan; Sanz, Antonio Salvador

doi:10.1016/j.transproceed.2008.08.112

Cited by 14 publications

(8 citation statements)

References 4 publications

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“…All of these aspects may also play an important role in post-heart transplant patients being frequently influenced by risk factors of diastolic dysfunction such as hypertension, diabetes mellitus, obesity, and metabolic syndrome [11][12][13][14][15][16] . As demonstrated previously 11 and confirmed in this study, systemic hypertension is a very common finding in patients after heart transplantation.…”

Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

Meluzı́n¹,

Hude²,

Leinveber³

et al. 2014

BIOMED PAP

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Aim. Post-heart transplant patients are at increased risk of diastolic dysfunction. The aim of this study was to assess the prevalence of isolated only exercise-induced heart failure with normal ejection fraction (HFNEF) in heart transplant recipients. Methods and Results. To determine pulmonary capillary wedge pressure (PCWP) at rest and during exercise, 81 patients after orthotopic heart transplantation with normal left ventricular ejection fraction (LVEF) underwent exercise right heart catheterization with simultaneous exercise echocardiography. Based on PCWP values, the patients were divided into three groups. Twenty-one patients had no evidence of HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise < 25 mmHg, prevalence 26%). Forty-seven subjects were found to have only exercise-induced HFNEF (PCWP at rest < 15 mmHg, maximal PCWP during exercise ≥ 25 mmHg, prevalence 58%). Thirteen patients had HFNEF already at rest (PCWP ≥ 15 mmHg at rest, prevalence 16%). Of the noninvasive parameters obtained at rest, multivariate regression analysis identified LV mass index adjusted for allograft age to be an independent predictor of exercise-induced HFNEF. Conclusions. In heart transplant recipients with normal LVEF, there is a high prevalence of exercise-induced HFNEF. LV mass index adjusted for allograft age is predictive of exercise-induced HFNEF.

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Section: Aspects Of Left Ventricular Filling Pressure Elevation and Dmentioning

confidence: 99%

High prevalence of exercise-induced heart failure with normal ejection fraction in post-heart transplant patients

Meluzı́n¹,

Hude²,

Leinveber³

et al. 2014

BIOMED PAP

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“…Дополнительными факторами риска, способствующи ми развитию АГ после ТС, считают: возраст донора, жен ский пол донора, анамнез АГ у донора, пожилой возраст реципиента, семейный анамнез АГ у реципиента, дис функцию аллографта, хроническое отторжение [3,[9][10][11]. В анализируемой нами группе несоответствие пола доно ра полу реципиента, хроническое отторжение трансплан тата, возраст и пол донора не ассоциировались с развити ем АГ (p>0,05).…”

Section: Discussionunclassified

Arterial hypertension after heart transplantation

et al. 2020

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Aim To evaluate incidence of arterial hypertension (AH) in the posttransplantation period and to identify risk factors for this complication.Materials and methods From January, 2010 through December, 2017, 96 heart transplantations (HT) (70 men and 26 women aged 46.5±13.9 years) were performed. During the first month following HT, 8 recipients died and were excluded from the analysis. The retrospective evaluation of results included 88 patients followed up for more than one year.Results For the entire post-HT period (maximum 92 months), AH was observed in 75 of 88 (85%) recipients. Post-HT AH was correlated with male gender (r=0.24; p=0.031), history of smoking before HT (r=0.45; p<0.001), history of ischemic heart disease (IHD) (r=0.28; p=0.01), older age (r=0.35; p=0.001), higher body weight index (r=0.37; p=0.0005), creatinine level (r=0.37; p=0.001), and low-density lipoprotein cholesterol level (r=0.27; p=0.04). Interrelations with other AH risk factors were not found. Most patients developed AH within the first two years after HT. During the first year, AH was diagnosed in 60% (53 of 88) of patients (relapse, 85% (n=29); newly diagnosed, 45% (n=24), p=0.0003). At two years, AH was detected in 79% (46 of 58) of patients (relapse, 53% (n=18); newly diagnosed, 53% (n=28), p=0.9). All recipients received an adequate antihypertensive therapy. 40-63% of patients required a single-drug therapy at different points of follow-up; from 29 to 45% of patients required a two-drug therapy, and 5-15% of patients required three or more drugs. During all 5 years of treatment, most patients used angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (70-87%) and slow calcium channel blockers (SCCB) (48-53%). The presence of AH following HT was associated with development of all cardiovascular events (CVE; r=0.31; p=0.012) whereas persistent AH, which required a combination antihypertensive treatment, was associated with a high mortality (r=0.61; p=0.015).Conclusion AH is a frequent complication of HT (85%), which is newly diagnosed in most patients during the first two years. AH incidence was higher for male recipients with a history of IHD, hypertension, and smoking. Approximately half of patients required only a single-drug antihypertensive therapy. After HT, the most frequently prescribed drugs included ACE inhibitors or ARBs and SCCBs (70-87% and 48-53%, respectively, depending on the time elapsed after HT). Persistent AH requiring a treatment with two or more antihypertensive drugs was associated with development of all CVEs and a higher long-term mortality.

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“…Antihypertensive therapy is required in up to 70% of patients post-transplantation 61. The incidence is higher in male recipients treated with ciclosporin 62.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence is higher in male recipients treated with ciclosporin 62. Dihydropyridine calcium channel antagonists and ACE inhibitors are commonly used as treatment 61. Hypertension also contributes to development of renal dysfunction and CAV 57 63…”

Section: Discussionmentioning

confidence: 99%