Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality

Max Liebo, Joshua Newman, Anjali Joshi, Brian D. Lowes, Yael Peled-Potashnik, Haseeb Ilias Basha, Ronald Zolty, John Y. Um, Edwin McGee, Alain Heroux, Eugenia Raichlin

Research output: Contribution to journalArticle

Abstract

Background: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes. Methods and Results: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41%) and HR <95 beats/min (n = 232; 59%). Median follow-up time was 6.6 (interquartile range [IQR] 2.2–7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E′ higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality. Conclusions: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.

Original languageEnglish (US)
Pages (from-to)249-256
Number of pages8
JournalJournal of Cardiac Failure
Volume25
Issue number4
DOIs
StatePublished - Apr 2019

Fingerprint

Heart Transplantation
Heart Rate
Transplants
Mortality
Allografts
Left Ventricular Function
African Americans
Alcohols
Tissue Donors
Survival

Keywords

  • cardiac allograft vasculopathy
  • heart rate
  • heart transplant
  • survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality. / Liebo, Max; Newman, Joshua; Joshi, Anjali; Lowes, Brian D.; Peled-Potashnik, Yael; Basha, Haseeb Ilias; Zolty, Ronald; Um, John Y.; McGee, Edwin; Heroux, Alain; Raichlin, Eugenia.

In: Journal of Cardiac Failure, Vol. 25, No. 4, 04.2019, p. 249-256.

Research output: Contribution to journalArticle

Liebo, M, Newman, J, Joshi, A, Lowes, BD, Peled-Potashnik, Y, Basha, HI, Zolty, R, Um, JY, McGee, E, Heroux, A & Raichlin, E 2019, 'Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality', Journal of Cardiac Failure, vol. 25, no. 4, pp. 249-256. https://doi.org/10.1016/j.cardfail.2019.01.009
Liebo, Max ; Newman, Joshua ; Joshi, Anjali ; Lowes, Brian D. ; Peled-Potashnik, Yael ; Basha, Haseeb Ilias ; Zolty, Ronald ; Um, John Y. ; McGee, Edwin ; Heroux, Alain ; Raichlin, Eugenia. / Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality. In: Journal of Cardiac Failure. 2019 ; Vol. 25, No. 4. pp. 249-256.
@article{235a787ca6ec4641a20261298ad14d5d,
title = "Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality",
abstract = "Background: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes. Methods and Results: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41{\%}) and HR <95 beats/min (n = 232; 59{\%}). Median follow-up time was 6.6 (interquartile range [IQR] 2.2–7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E′ higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality. Conclusions: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.",
keywords = "cardiac allograft vasculopathy, heart rate, heart transplant, survival",
author = "Max Liebo and Joshua Newman and Anjali Joshi and Lowes, {Brian D.} and Yael Peled-Potashnik and Basha, {Haseeb Ilias} and Ronald Zolty and Um, {John Y.} and Edwin McGee and Alain Heroux and Eugenia Raichlin",
year = "2019",
month = "4",
doi = "10.1016/j.cardfail.2019.01.009",
language = "English (US)",
volume = "25",
pages = "249--256",
journal = "Journal of Cardiac Failure",
issn = "1071-9164",
publisher = "Churchill Livingstone",
number = "4",

}

TY - JOUR

T1 - Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality

AU - Liebo, Max

AU - Newman, Joshua

AU - Joshi, Anjali

AU - Lowes, Brian D.

AU - Peled-Potashnik, Yael

AU - Basha, Haseeb Ilias

AU - Zolty, Ronald

AU - Um, John Y.

AU - McGee, Edwin

AU - Heroux, Alain

AU - Raichlin, Eugenia

PY - 2019/4

Y1 - 2019/4

N2 - Background: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes. Methods and Results: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41%) and HR <95 beats/min (n = 232; 59%). Median follow-up time was 6.6 (interquartile range [IQR] 2.2–7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E′ higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality. Conclusions: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.

AB - Background: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes. Methods and Results: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41%) and HR <95 beats/min (n = 232; 59%). Median follow-up time was 6.6 (interquartile range [IQR] 2.2–7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E′ higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality. Conclusions: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.

KW - cardiac allograft vasculopathy

KW - heart rate

KW - heart transplant

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=85062353718&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062353718&partnerID=8YFLogxK

U2 - 10.1016/j.cardfail.2019.01.009

DO - 10.1016/j.cardfail.2019.01.009

M3 - Article

C2 - 30685400

AN - SCOPUS:85062353718

VL - 25

SP - 249

EP - 256

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 4

ER -