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Long-term prognostic value of elevated heart rate one year after heart transplantation.
MedLine Citation:
PMID:  23336956     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Elevated heart rate (HR) is associated with adverse cardiovascular outcome in the general population and in patients with cardiovascular disease. Elevated HR due to graft denervation is often found in heart transplantation (HTx) patients; the effect on graft survival and vasculopathy is unclear. Thus, the aim of this study was to evaluate the role of elevated HR at 12months post-HTx and its power to predict HTx long-term outcome. METHODS: We evaluated retrospectively a prospective database of 312 patients undergoing HTx at two centers. HR was registered at 12months post-HTx. The median HR was used as a cutoff point. Cox regression analysis was performed with variables known to be clinically relevant to mortality and those selected from the univariate analysis. RESULTS: During a mean follow-up of 5.5±2.8years there were 58 deaths (19%). Patients with a HR ≥90bpm (median HR) at 12months had an increased risk for all-cause mortality (Hazard Ratio=2.4, 95% CI 1.2 to 4.5, p=0.009) and mortality related to coronary allograft vasculopathy (CAV) (Hazard Ratio=3.0, 95% CI 1.25-7.14, p=0.01). Multivariate analysis showed that a HR ≥90bpm independently predicted mortality (HR 3.2, 95% CI 1.4-7.1, p=0.004). CONCLUSIONS: Elevated HR measured at 12months after HTx is an independent predictor of all-cause mortality in HTx recipients. A HR ≥90bpm identifies a group of patients at high risk of death and CAV-related mortality at mid- to long-term.
Authors:
María Ángeles Castel; Eulàlia Roig; José Rios; Carles Tomas; Sonia Mirabet; Montserrat Cardona; Vicens Brossa; Laura López; Luis Vargas; Alessandro Sionis; Isabel Vallejos; Félix Pérez-Villa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-18
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Thorax Clinic Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain. Electronic address: macastel@clinic.ub.es.
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