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Heart rate and early progression of cardiac allograft vasculopathy: A prospective study using highly automated 3‐D optical coherence tomography analysis
Author(s) -
Pazdernik Michal,
Wichterle Dan,
Chen Zhi,
Bedanova Helena,
Kautzner Josef,
Melenovsky Vojtech,
Karmazin Vladimir,
Malek Ivan,
Stiavnicky Peter,
Tomasek Ales,
Ozabalova Eva,
Krejci Jan,
Wahle Andreas,
Zhang Honghai,
Kovarnik Tomas,
Sonka Milan
Publication year - 2020
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.13773
Subject(s) - medicine , cardiac allograft vasculopathy , cardiology , prospective cohort study , ambulatory , optical coherence tomography , heart transplantation , heart rate , beta blocker , ambulatory ecg , single center , heart disease , carvedilol , heart failure , radiology , blood pressure
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 2 ( 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.