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Titolo:
IMPORTANCE OF DECREASED HEART-RATE IN PREDICTING TRANSPLANT CORONARY-ARTERY DISEASE
Autore:
GULLESTAD L; ROSS H; MYERS J; HOANG K; HUNT S; STINSON EB; VALENTINE HA;
Indirizzi:
STANFORD UNIV,SCH MED,FALK CARDIOVASC RES CTR,300 PASTEUR DR STANFORDCA 94305 STANFORD UNIV,SCH MED,FALK CARDIOVASC RES CTR STANFORD CA 94305
Titolo Testata:
Clinical transplantation
fascicolo: 6, volume: 11, anno: 1997,
pagine: 628 - 632
SICI:
0902-0063(1997)11:6<628:IODHIP>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRACORONARY ULTRASOUND; CARDIAC TRANSPLANTATION; ATHEROSCLEROSIS; RECIPIENTS; REJECTION; INFECTION; CELLS;
Keywords:
CORONARY ARTERY DISEASE; HEART TRANSPLANT RECIPIENTS; HEART RATE;
Tipo documento:
Article
Natura:
Periodico
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
L. Gullestad et al., "IMPORTANCE OF DECREASED HEART-RATE IN PREDICTING TRANSPLANT CORONARY-ARTERY DISEASE", Clinical transplantation, 11(6), 1997, pp. 628-632

Abstract

Studies in animals and humans have demonstrated that an increased heart rate is a predictor for the development of coronary atherosclerosisand overall cardiovascular mortality. In contrast, we have previouslyreported that the need for pacemaker implantation because of bradycardia in heart transplant recipients is associated with an increased prevalence of transplant coronary artery disease (TxCAD). Hence, the relevance of changes in heart rate to the development of TxCAD remains unclear. Intracoronary ultrasound examinations (ICUS) were therefore analyzed in 130 heart transplant recipients (age 50 +/- Il yr) studied at annual evaluations (3.7 +/- 3.0 yr after transplantation). Quantitative ultrasound measurements were obtained by calculating mean coronary artery intimal thickness (MIT) obtained by examination of the left anterior descending artery. The presence of TxCAD was defined as MIT > 0.3mm. Resting heart rates (HR) were recorded with the patients in the supine position during routine echocardiography. Based on HR recordings, two groups were defined: group 1, HR below; or group 2, HR above themedian. TxCAD was detected in 40% of the ICUS studies overall. The prevalence of TxCAD was higher in group 1 (49%) compared with group 2 (33%), p<0.05. There was no significant difference in donor ischemic time or donor gender, recipient age, gender, body weight, CMV status, creatinine, total cholesterol, use of lipid lowering drugs or diltiazem. Donor age and use of beta-blockers were higher in group 1 compared with group 2 (29 +/- 10 vs. 25 +/- 9 yr, and 15% vs. 5%, for donor age and beta-blocker use, respectively). By multivariate regression analysisonly donor age and years after transplantation were independently correlated with TxCAD. After excluding patients taking beta-blockers and diltiazem, the prevalence of CAD was still higher in group 1 (50%) vs.group 2 (34%). In conclusion, transplant coronary artery disease is more prevalent in patients with lower. rather than higher, heart rates. The reason for this is unclear, but may reflect impaired blood flow to the sinoatrial node.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 16:42:39