Related Experiment Video
Updated: Jul 29, 2025
06:26
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
8.0K
Chronotropic Incompetence after Heart Transplantation Is Associated with Increased Mortality and Decreased Functional
Robert S Zhang1, Thomas C Hanff2,3, Yuhui Zhang4
1Division of Cardiovascular Medicine, NYU Langone Health, New York, NY 10016, USA.
Journal of Clinical Medicine
|May 27, 2023
Summary
A low heart rate response (HRR) after heart transplant is linked to poorer survival and reduced exercise capacity. Improving HRR may enhance outcomes for heart transplant recipients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Exercise Physiology
Background:
- Chronotropic incompetence is known to reduce exercise tolerance post-heart transplant.
- The prognostic value of post-transplant heart rate response (HRR) for mortality remains unclear.
Purpose of the Study:
- To investigate the association between post-transplant heart rate response (HRR) and patient survival.
- To determine if HRR can serve as a prognostic marker for mortality after heart transplantation.
Main Methods:
- Retrospective analysis of adult heart transplant recipients (2000-2011) with cardiopulmonary exercise testing (CPET) within one year.
- HRR calculated as peak exercise heart rate minus resting heart rate.
- Cox proportional hazard models and Kaplan-Meier analysis used to assess HRR's impact on mortality.
Main Results:
- In 210 patients, each beat/min increase in HRR correlated with a 3% reduction in mortality hazard (HR 0.97).
- Higher survival rates were observed in patients with HRR > 35 beats/min compared to those with HRR < 35 beats/min (log rank p=0.0012).
- Increased HRR was associated with improved peak oxygen consumption and exercise duration.
Conclusions:
- A low heart rate response (HRR) in heart transplant recipients is associated with increased all-cause mortality.
- Reduced exercise capacity is also linked to a low HRR post-heart transplant.
- Further research is needed to explore HRR targeting in cardiac rehabilitation to improve patient outcomes.
More Related Videos
Related Concept Videos
01:28Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:30Cardiomyopathy II: Dilated Cardiomyopathy
12
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
12
01:27Heart Failure I: Introduction
24
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
24
01:17Pathophysiology of Heart Failure
1.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K
01:29Heart Failure II: Pathophysiology
16
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
16