Related Experiment Video
Updated: May 15, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Long-term prognostic value of elevated heart rate one year after heart transplantation
María Ángeles Castel1, Eulàlia Roig, José Rios
1Thorax Clinic Institute, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
Insights
Elevated heart rate (HR) after heart transplantation (HTx) is linked to higher mortality. A HR of 90 bpm or more at 12 months post-HTx predicts increased risk of death and graft vasculopathy.
Area of Science:
- Cardiology
- Transplantation Medicine
- Clinical Outcomes Research
Background:
- Elevated heart rate (HR) is a known risk factor for adverse cardiovascular outcomes.
- In heart transplantation (HTx) recipients, elevated HR post-surgery, often due to graft denervation, has an unclear impact on long-term graft survival and vasculopathy.
Purpose of the Study:
- To investigate the role of elevated HR at 12 months post-HTx.
- To determine if HR predicts long-term outcomes in heart transplant recipients.
Main Methods:
- Retrospective analysis of a prospective database of 312 HTx patients.
- HR measured at 12 months post-transplant, with median HR used as a cutoff (≥ 90 bpm).
- Cox regression analysis, including clinically relevant variables and those from univariate analysis, to assess mortality risk.
Main Results:
- During a mean follow-up of 5.5 years, 58 deaths (19%) occurred.
- Patients with HR ≥ 90 bpm at 12 months had significantly increased risk of all-cause mortality (HR=2.4) and coronary allograft vasculopathy (CAV)-related mortality (HR=3.0).
- Multivariate analysis confirmed HR ≥ 90 bpm as an independent predictor of mortality (HR=3.2).
Conclusions:
- Elevated HR at 12 months post-HTx is an independent predictor of all-cause mortality.
- A HR ≥ 90 bpm identifies HTx recipients at high risk for mortality and CAV-related death in the mid- to long-term.
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 12 months 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 12 months 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 ± 2.8 years there were 58 deaths (19%). Patients with a HR ≥ 90 bpm (median HR) at 12 months 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 ≥ 90 bpm independently predicted mortality (HR 3.2, 95% CI 1.4-7.1, p=0.004).
Conclusions:
Elevated HR measured at 12 months after HTx is an independent predictor of all-cause mortality in HTx recipients. A HR ≥ 90 bpm identifies a group of patients at high risk of death and CAV-related mortality at mid- to long-term.
