Effect of diltiazem on exercise capacity after heart transplantation

Sara Varnado, Yael Peled-Potashnik, Ashley Huntsberry, Brian D Lowes, Ronald Zolty, Adam Burdorf, Elizabeth R. Lyden, Michael J Moulton, John Y Um, Eugenia Raichlin

Research output: Contribution to journalArticle

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Abstract

Background: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function, and exercise capacity. Methods: From the total cohort, 25 HTx recipients started diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at 1 year after HTx. Results: HR decreased in the diltiazem group from 99±11 bpm to 94±7 bpm (P=.03) and did not change in the controls (98±11 bpm vs 100±13 bpm, P=.14). The difference between the groups at 1 year after HTx was significant (P=.04). In the diltiazem group left ventricular (LV), stroke volume and ejection fraction increased (48±16 vs 55±17 mL, P=.02, and 60%±10% vs 62%±12% P=.03, respectively) but did not differ from controls. E/E' decreased (10.7±2.7 vs 7.3±1.9, P=.003) while cardiac index was higher (3.5±0.8 vs 3.1±0.5; P=.05) in the diltiazem group at 1-year follow-up. The absolute peak VO2 (21±4 vs 18±6 mL/kg/min; P=.05) and normalized peak VO2 (73%±17% vs 58%±14%; P=.004) were significantly higher in the diltiazem group. Conclusions: This study showed that diltiazem treatment reduces ST, may improve cardiac allograft function and exercise tolerance during the first year after HTx.

Original languageEnglish (US)
Article numbere12997
JournalClinical Transplantation
Volume31
Issue number8
DOIs
StatePublished - Aug 1 2017

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Diltiazem
Heart Transplantation
Exercise
Sinus Tachycardia
Heart Rate
Transplantation Tolerance
Exercise Tolerance
Exercise Test
Stroke Volume
Allografts
Therapeutics
Hemodynamics

Keywords

  • complication
  • dysfunction
  • heart (allograft) function
  • quality of life

ASJC Scopus subject areas

  • Transplantation

Cite this

Varnado, S., Peled-Potashnik, Y., Huntsberry, A., Lowes, B. D., Zolty, R., Burdorf, A., ... Raichlin, E. (2017). Effect of diltiazem on exercise capacity after heart transplantation. Clinical Transplantation, 31(8), [e12997]. https://doi.org/10.1111/ctr.12997

Effect of diltiazem on exercise capacity after heart transplantation. / Varnado, Sara; Peled-Potashnik, Yael; Huntsberry, Ashley; Lowes, Brian D; Zolty, Ronald; Burdorf, Adam; Lyden, Elizabeth R.; Moulton, Michael J; Um, John Y; Raichlin, Eugenia.

In: Clinical Transplantation, Vol. 31, No. 8, e12997, 01.08.2017.

Research output: Contribution to journalArticle

Varnado, S, Peled-Potashnik, Y, Huntsberry, A, Lowes, BD, Zolty, R, Burdorf, A, Lyden, ER, Moulton, MJ, Um, JY & Raichlin, E 2017, 'Effect of diltiazem on exercise capacity after heart transplantation', Clinical Transplantation, vol. 31, no. 8, e12997. https://doi.org/10.1111/ctr.12997
Varnado S, Peled-Potashnik Y, Huntsberry A, Lowes BD, Zolty R, Burdorf A et al. Effect of diltiazem on exercise capacity after heart transplantation. Clinical Transplantation. 2017 Aug 1;31(8). e12997. https://doi.org/10.1111/ctr.12997
Varnado, Sara ; Peled-Potashnik, Yael ; Huntsberry, Ashley ; Lowes, Brian D ; Zolty, Ronald ; Burdorf, Adam ; Lyden, Elizabeth R. ; Moulton, Michael J ; Um, John Y ; Raichlin, Eugenia. / Effect of diltiazem on exercise capacity after heart transplantation. In: Clinical Transplantation. 2017 ; Vol. 31, No. 8.
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abstract = "Background: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function, and exercise capacity. Methods: From the total cohort, 25 HTx recipients started diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at 1 year after HTx. Results: HR decreased in the diltiazem group from 99±11 bpm to 94±7 bpm (P=.03) and did not change in the controls (98±11 bpm vs 100±13 bpm, P=.14). The difference between the groups at 1 year after HTx was significant (P=.04). In the diltiazem group left ventricular (LV), stroke volume and ejection fraction increased (48±16 vs 55±17 mL, P=.02, and 60{\%}±10{\%} vs 62{\%}±12{\%} P=.03, respectively) but did not differ from controls. E/E' decreased (10.7±2.7 vs 7.3±1.9, P=.003) while cardiac index was higher (3.5±0.8 vs 3.1±0.5; P=.05) in the diltiazem group at 1-year follow-up. The absolute peak VO2 (21±4 vs 18±6 mL/kg/min; P=.05) and normalized peak VO2 (73{\%}±17{\%} vs 58{\%}±14{\%}; P=.004) were significantly higher in the diltiazem group. Conclusions: This study showed that diltiazem treatment reduces ST, may improve cardiac allograft function and exercise tolerance during the first year after HTx.",
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AU - Peled-Potashnik, Yael

AU - Huntsberry, Ashley

AU - Lowes, Brian D

AU - Zolty, Ronald

AU - Burdorf, Adam

AU - Lyden, Elizabeth R.

AU - Moulton, Michael J

AU - Um, John Y

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N2 - Background: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function, and exercise capacity. Methods: From the total cohort, 25 HTx recipients started diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at 1 year after HTx. Results: HR decreased in the diltiazem group from 99±11 bpm to 94±7 bpm (P=.03) and did not change in the controls (98±11 bpm vs 100±13 bpm, P=.14). The difference between the groups at 1 year after HTx was significant (P=.04). In the diltiazem group left ventricular (LV), stroke volume and ejection fraction increased (48±16 vs 55±17 mL, P=.02, and 60%±10% vs 62%±12% P=.03, respectively) but did not differ from controls. E/E' decreased (10.7±2.7 vs 7.3±1.9, P=.003) while cardiac index was higher (3.5±0.8 vs 3.1±0.5; P=.05) in the diltiazem group at 1-year follow-up. The absolute peak VO2 (21±4 vs 18±6 mL/kg/min; P=.05) and normalized peak VO2 (73%±17% vs 58%±14%; P=.004) were significantly higher in the diltiazem group. Conclusions: This study showed that diltiazem treatment reduces ST, may improve cardiac allograft function and exercise tolerance during the first year after HTx.

AB - Background: Sinus tachycardia (ST) is common after heart transplantation (HTx). The aim of the study was to evaluate the effect of diltiazem treatment during the first year after HTx on heart rate (HR), cardiac allograft function, and exercise capacity. Methods: From the total cohort, 25 HTx recipients started diltiazem treatment 4±2 weeks after HTx and continued it for at least 1 year (diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test (CPET) at 1 year after HTx. Results: HR decreased in the diltiazem group from 99±11 bpm to 94±7 bpm (P=.03) and did not change in the controls (98±11 bpm vs 100±13 bpm, P=.14). The difference between the groups at 1 year after HTx was significant (P=.04). In the diltiazem group left ventricular (LV), stroke volume and ejection fraction increased (48±16 vs 55±17 mL, P=.02, and 60%±10% vs 62%±12% P=.03, respectively) but did not differ from controls. E/E' decreased (10.7±2.7 vs 7.3±1.9, P=.003) while cardiac index was higher (3.5±0.8 vs 3.1±0.5; P=.05) in the diltiazem group at 1-year follow-up. The absolute peak VO2 (21±4 vs 18±6 mL/kg/min; P=.05) and normalized peak VO2 (73%±17% vs 58%±14%; P=.004) were significantly higher in the diltiazem group. Conclusions: This study showed that diltiazem treatment reduces ST, may improve cardiac allograft function and exercise tolerance during the first year after HTx.

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KW - dysfunction

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KW - quality of life

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