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Effect of diltiazem on exercise capacity after heart transplantation
Author(s) -
Varnado Sara,
PeledPotashnik Yael,
Huntsberry Ashley,
Lowes Brian D.,
Zolty Ronald,
Burdorf Adam,
Lyden Elizabeth R.,
Moulton Michael J.,
Um John Y.,
Raichlin Eugenia
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12997
Subject(s) - diltiazem , medicine , ejection fraction , stroke volume , cardiology , heart transplantation , heart rate , transplantation , cardiac index , hemodynamics , cardiac function curve , cardiac output , sinus tachycardia , anesthesia , blood pressure , heart failure , calcium
Background Sinus tachycardia ( ST ) is common after heart transplantation ( HT x). The aim of the study was to evaluate the effect of diltiazem treatment during the first year after HT x on heart rate ( HR ), cardiac allograft function, and exercise capacity. Methods From the total cohort, 25 HT x recipients started diltiazem treatment 4±2 weeks after HT x and continued it for at least 1 year (diltiazem group). Each study case was matched to a control. All patients underwent hemodynamic assessment and cardiopulmonary exercise test ( CPET ) at 1 year after HT x. Results HR decreased in the diltiazem group from 99±11 bpm to 94±7 bpm ( P =.03) and did not change in the controls (98±11 bpm vs 100±13 bpm, P =.14). The difference between the groups at 1 year after HT x was significant ( P =.04). In the diltiazem group left ventricular ( LV ), stroke volume and ejection fraction increased (48±16 vs 55±17 mL, P =.02, and 60%±10% vs 62%±12% P =.03, respectively) but did not differ from controls. E/E' decreased (10.7±2.7 vs 7.3±1.9, P =.003) while cardiac index was higher (3.5±0.8 vs 3.1±0.5; P =.05) in the diltiazem group at 1‐year follow‐up. The absolute peak VO 2 (21±4 vs 18±6 mL/kg/min; P =.05) and normalized peak VO 2 (73%±17% vs 58%±14%; P =.004) were significantly higher in the diltiazem group. Conclusions This study showed that diltiazem treatment reduces ST , may improve cardiac allograft function and exercise tolerance during the first year after HT x.