Impact of basal heart rate on long-term prognosis of heart transplant patients

Melero-Ferrer, J.; Sánchez‐Lázaro, Ignacio; Almenar‐Bonet, Luis; Martínez‐Dolz, Luis; Buendía-Fuentes, Francisco; Portolés, Manuel; Rivera-Otero, M.; Salvador-Sanz, Antonio

doi:10.1111/tri.12082

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…Anand (9) showed on a set of 78 patients that patients with resting heart rate higher than 90/min after 3 months from transplantation are 2.8 times more likely to die than those with the heart rate 90/min or lower. The same conclusion was reached by Ferrer et al (15), who demonstrated on a set of 191 patients that resting heart rate of 100/min and above is an independent risk factor for mortality. Higher heart rate presents the risk also in a longer period from transplantation.…”

Section: Discussionsupporting

confidence: 73%

Association between the heart rate early after heart transplantation and the long term clinical outcomes

Bedáňová¹,

Fila²,

Horváth³

et al. 2017

BLL

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BACKGROUND: A strong correlation between a lower heart rate and survival has been demonstrated in various patient populations. The optimal heart rate for heart transplant patients is still unknown. The aim of our study was to evaluate the association between an early heart rate and survival after heart transplantation. MATERIAL AND METHODS: We retrospectively analysed a group of 330 patients, who underwent heart transplantation in our institution from 1994 to 2014 and complete datasets, including 24-hour heart rate monitoring one month after the heart transplantation. Patients were divided in 2 groups: Group A (n = 278) with the average 24-hour heart rate < 90 bpm, and Group B (n = 52) with ≥ 90 bpm. RESULTS: The average period of monitoring was 7.5 ± 5.3 years. No differences in baseline characteristics were observed in both groups of recipients and respective donors. One-year survival in groups A and B was 92 % and 81 %, respectively; 5-year survival was 79 % and 60 %, respectively; and 10-year survival was 66 % and 50 %, respectively (p = 0.001). CONCLUSION: Increased heart rate in the early post-transplant period was signifi cantly associated with a poorer survival rate in patients after heart transplantation (Tab. 2, Fig. 1, Ref. 25). Text in PDF www.elis.sk. KEY WORDS: heart rate early heart transplantation, long term clinical outcomes.

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Section: Discussionsupporting

confidence: 73%

Association between the heart rate early after heart transplantation and the long term clinical outcomes

Bedáňová¹,

Fila²,

Horváth³

et al. 2017

BLL

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“…66 A resting HR ≥90 or 100 beats per minute (bpm) in early recipients at 1 year post-HTx was found in multivariate analyses to be an independent predictor of mortality following transplantation. 67,68 Recipients with higher baseline HR ≥90 bpm at 1 year post-HTx had lower survival rates at 3, 5, and 10 years post-HTx when compared with recipients with HR <90 bpm. 68 Although some early (denervated) and late (possibly reinnervated) recipients were found to have a higher HR at rest when compared with controls, 21,23,27,29 and others showed a similar resting HR, 4,12 HR measurements were found to be higher in recipients within 3 years post-HTx when compared with recipients more than 3 years post-HTx.…”

Section: Cardiac Reinnervationmentioning

confidence: 92%

“…The absence of vagal reinnervation and the presence of sympathetic reinnervation may explain the association between increased HR at rest and increased leptin levels through cardiac leptin receptors . A resting HR ≥90 or 100 beats per minute (bpm) in early recipients at 1 year post‐HTx was found in multivariate analyses to be an independent predictor of mortality following transplantation . Recipients with higher baseline HR ≥90 bpm at 1 year post‐HTx had lower survival rates at 3, 5, and 10 years post‐HTx when compared with recipients with HR <90 bpm …”

Section: Heart Rate At Restmentioning

confidence: 99%

Early Denervation and Later Reinnervation of the Heart Following Cardiac Transplantation: A Review

Awad

Czer

Hou

et al. 2016

JAHA

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“…Two studies in adult HTx patients have found resting HR > 100 b.p.m. 15 and HR > 90 b.p.m. 16 to be associated with higher mortality.…”

Section: Introductionmentioning

confidence: 93%

“…Furthermore, two studies in paediatric HTx patients reported absence of suggestive reinnervation based on HR recovery 13 or HR variability 14 to be associated with worse outcome. Two studies in adult HTx patients have found resting HR > 100 b.p.m 15 . and HR > 90 b.p.m 16 .…”

Section: Introductionmentioning

confidence: 99%

Heart rate kinetics during standard cardiopulmonary exercise testing in heart transplant recipients: a longitudinal study

et al. 2021

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Aims Heart transplantation (HTx) results in complete autonomic denervation of the donor heart, causing resting tachycardia and abnormal heart rate (HR) responses to exercise. We determined the time course of suggestive cardiac reinnervation post HTx and investigated its clinical significance. Methods and results Heart rate kinetics during standard cardiopulmonary exercise testing at 2.5-5 years after HTx was assessed in 58 patients. According to their HR increase 30 s after exercise onset, HTx recipients were classified as denervated (slow responders: <5 beats per minute [b.p.m.]) or potentially reinnervated (fast responders: ≥5 b.p.m.). Additionally, in 30 patients, longitudinal changes of maximal oxygen consumption and HR kinetics were assessed during the first 15 post-operative years. At 2.5-5 years post HTx, 38% of our study population was potentially reinnervated. Fast responders were significantly younger (41 ± 15 years) than slow responders (53 ± 13 years, P = 0.003) but did not differ with regard to donor age, immunosuppressive regime, cardiovascular risk factors, endomyocardial biopsy, or vasculopathy parameters. While HR reserve (56 ± 20 vs. 39 ± 15 b.p.m., P = 0.002) and HR recovery after 60 s (15 ± 11 vs. 5 ± 6 b.p.m., P < 0.001) were greater in fast responders, resting HR, peak HR of predicted, and peak oxygen consumption of predicted were comparable. Conclusions Signs of reinnervation occurred mainly in younger patients. Maximal oxygen consumption was independent of HR kinetics.

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Impact of basal heart rate on long-term prognosis of heart transplant patients

Cited by 14 publications

References 26 publications

Association between the heart rate early after heart transplantation and the long term clinical outcomes

Association between the heart rate early after heart transplantation and the long term clinical outcomes

Early Denervation and Later Reinnervation of the Heart Following Cardiac Transplantation: A Review

Heart rate kinetics during standard cardiopulmonary exercise testing in heart transplant recipients: a longitudinal study

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