Heart Rate and Early Progression of Cardiac Allograft Vasculopathy: A Prospective Study Using Highly Automated 3-D Optical Coherence Tomography Analysis

Overview

Journal Clin Transplant

Specialty General Surgery

Date 2019 Dec 21

PMID 31859379

Citations 3

Authors

Michal Pazdernik

Dan Wichterle

Zhi Chen

Helena Bedanova

Josef Kautzner

Vojtech Melenovsky

Vladimir Karmazin

Ivan Malek

Peter Stiavnicky

Ales Tomasek

Eva Ozabalova

Jan Krejci

Andreas Wahle

Honghai Zhang

Tomas Kovarnik

Milan Sonka

Affiliations

Soon will be listed here.

Abstract

Introduction: Heart rate slowing agents are frequently prescribed to manage heart transplant (HTx) patients with the assumption that higher heart rate is a risk factor in cardiovascular disease.

Patients And Methods: This prospective two-center study investigated early progression of cardiac allograft vasculopathy (CAV) in 116 HTx patients. Examinations by coronary optical coherence tomography and 24-hour ambulatory ECG monitoring were performed both at baseline (1 month after HTx) and during follow-up (12 months after HTx).

Results: During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area from 9.0 ± 2.5 to 8.0 ± 2.4 mm (P < .001), and progression in mean intimal thickness (IT) from 106.5 ± 40.4 to 130.1 ± 53.0 µm (P < .001). No significant relationship was observed between baseline and follow-up mean heart rates and IT progression (R = .02, P = .83; R = -.13, P = .18). We found a mild inverse association between beta-blocker dosage at 12 months and IT progression (R = -.20, P = .035).

Conclusion: Our study did not confirm a direct association between mean heart rate and progression of CAV. The role of beta blockers warrants further investigation, with our results indicating that they may play a protective role in early CAV development.

Citing Articles

Implications of Preoperative C-Reactive Protein Levels in Heart Transplant Patients-A Single-Center Retrospective Study.

Huma L, Suciu H, Avram C, Suteu R, Danilesco A, Baba D J Clin Med. 2024; 13(23).

PMID: 39685924 PMC: 11641936. DOI: 10.3390/jcm13237466.

Tricuspid Annular Plane Systolic Excursion-to-Systolic Pulmonary Artery Pressure Ratio as a Prognostic Factor in Heart Transplant Patients.

Huma L, Suciu H, Avram C, Suteu R, Danilesco A, Baba D Medicina (Kaunas). 2024; 60(7).

PMID: 39064507 PMC: 11279045. DOI: 10.3390/medicina60071078.

The Impact of Beta Blockers on Survival in Heart Transplant Recipients: Insights from the Zabrze HTx Registry.

Kubiak G, Kwiecinski R, Ciarka A, Tukiendorf A, Przybylowski P, Hrapkowicz T Cardiol Res Pract. 2020; 2020:5190248.

PMID: 32774914 PMC: 7396039. DOI: 10.1155/2020/5190248.

References

Wachter S, McCandless S, Gilbert E, Stoddard G, Kfoury A, Reid B . Elevated resting heart rate in heart transplant recipients: innocent bystander or adverse prognostic indicator?. Clin Transplant. 2015; 29(9):829-34. DOI: 10.1111/ctr.12587. View

Clemmensen T, Holm N, Eiskjaer H, Jakobsen L, Berg K, Neghabat O . Detection of early changes in the coronary artery microstructure after heart transplantation: A prospective optical coherence tomography study. J Heart Lung Transplant. 2017; 37(4):486-495. DOI: 10.1016/j.healun.2017.10.014. View

Matsuo Y, Cassar A, Yoshino S, Flammer A, Li J, Gulati R . Attenuation of cardiac allograft vasculopathy by sirolimus: Relationship to time interval after heart transplantation. J Heart Lung Transplant. 2013; 32(8):784-91. PMC: 3727915. DOI: 10.1016/j.healun.2013.05.015. View

Pazdernik M, Chen Z, Bedanova H, Kautzner J, Melenovsky V, Karmazin V . Early detection of cardiac allograft vasculopathy using highly automated 3-dimensional optical coherence tomography analysis. J Heart Lung Transplant. 2018; 37(8):992-1000. DOI: 10.1016/j.healun.2018.04.002. View

Sekar B, Critchley W, Williams S, Shaw S . Should we consider heart rate reduction in cardiac transplant recipients?. Clin Cardiol. 2012; 36(2):68-73. PMC: 6649618. DOI: 10.1002/clc.22048. View

Liebo M, Newman J, Joshi A, Lowes B, Peled-Potashnik Y, Basha H . Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality. J Card Fail. 2019; 25(4):249-256. DOI: 10.1016/j.cardfail.2019.01.009. View

Verani M, Nishimura S, Mahmarian J, Hays J, Young J . Cardiac function after orthotopic heart transplantation: response to postural changes, exercise, and beta-adrenergic blockade. J Heart Lung Transplant. 1994; 13(2):181-93. View

Tsutsui H, Ziada K, Schoenhagen P, Iyisoy A, Magyar W, Crowe T . Lumen loss in transplant coronary artery disease is a biphasic process involving early intimal thickening and late constrictive remodeling: results from a 5-year serial intravascular ultrasound study. Circulation. 2001; 104(6):653-7. DOI: 10.1161/hc3101.093867. View

Abraham W . Switching to evidence-based once-daily beta-blockers for improved adherence to medication across the continuum of post-myocardial infarction left ventricular dysfunction and heart failure. Congest Heart Fail. 2008; 14(5):272-80. DOI: 10.1111/j.1751-7133.2008.00013.x. View

10.

Ghafourian K, Kobashigawa J . Slowing Sinus Tachycardia in Heart Transplant Recipients: Is It Time?. Rev Esp Cardiol (Engl Ed). 2015; 68(11):921-3. DOI: 10.1016/j.rec.2015.07.016. View

11.

Cooney M, Vartiainen E, Laatikainen T, Laakitainen T, Juolevi A, Dudina A . Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women. Am Heart J. 2010; 159(4):612-619.e3. DOI: 10.1016/j.ahj.2009.12.029. View

12.

Moghtadaei M, Jansen H, Mackasey M, Rafferty S, Bogachev O, Sapp J . The impacts of age and frailty on heart rate and sinoatrial node function. J Physiol. 2016; 594(23):7105-7126. PMC: 5134407. DOI: 10.1113/JP272979. View

13.

Cassar A, Matsuo Y, Herrmann J, Li J, Lennon R, Gulati R . Coronary atherosclerosis with vulnerable plaque and complicated lesions in transplant recipients: new insight into cardiac allograft vasculopathy by optical coherence tomography. Eur Heart J. 2013; 34(33):2610-7. PMC: 3758840. DOI: 10.1093/eurheartj/eht236. View

14.

Castel M, Roig E, Rios J, Tomas C, Mirabet S, Cardona M . Long-term prognostic value of elevated heart rate one year after heart transplantation. Int J Cardiol. 2013; 168(3):2003-7. DOI: 10.1016/j.ijcard.2012.12.089. View

15.

Fox K, Borer J, Camm A, Danchin N, Ferrari R, Lopez Sendon J . Resting heart rate in cardiovascular disease. J Am Coll Cardiol. 2007; 50(9):823-30. DOI: 10.1016/j.jacc.2007.04.079. View

16.

Sun S, Sonka M, Beichel R . Graph-based IVUS segmentation with efficient computer-aided refinement. IEEE Trans Med Imaging. 2013; 32(8):1536-49. PMC: 3883441. DOI: 10.1109/TMI.2013.2260763. View

17.

Ciarka A, Lund L, Van Cleemput J, Voros G, Droogne W, Vanhaecke J . Effect of Heart Rate and Use of Beta Blockers on Mortality After Heart Transplantation. Am J Cardiol. 2016; 118(12):1916-1921. DOI: 10.1016/j.amjcard.2016.08.084. View

18.

Chen Z, Pazdernik M, Zhang H, Wahle A, Guo Z, Bedanova H . Quantitative 3D Analysis of Coronary Wall Morphology in Heart Transplant Patients: OCT-Assessed Cardiac Allograft Vasculopathy Progression. Med Image Anal. 2018; 50:95-105. PMC: 6237624. DOI: 10.1016/j.media.2018.09.003. View

19.

Khandhar S, Yamamoto H, Teuteberg J, Shullo M, Bezerra H, Costa M . Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation (OCTCAV study). J Heart Lung Transplant. 2013; 32(6):596-602. DOI: 10.1016/j.healun.2013.02.005. View

20.

Ambrosi P, Kreitmann B, Habib G . Does heart rate predict allograft vasculopathy in heart transplant recipients?. Int J Cardiol. 2009; 145(2):256-257. DOI: 10.1016/j.ijcard.2009.08.031. View