Increase in systolic blood pressure during exercise testing after heart transplantation: correlation with the clinical condition and ventricular function assessed by dobutamine stress echocardiography.
OBJECTIVE
Patients who underwent heart transplantation (HTX) experience a reduction in the elevation that is usual in systolic blood pressure during exercise testing. Of unknown origin, this phenomenon varies in frequency and intensity. The aim of this study was to analyze the relationship between systolic blood pressure increase (delta SBP) and clinical aspects, as well as variables measured during exercise testing (ET) and dobutamine stress echocardiography (DSE) in patients in the late post-transplantation course.


METHODS
Forty-five men, mean age 49.04 +/- 10.19, underwent clinical assessment, ET and DSE 40.91 +/- 27.46 months after heart transplantation. Left ventricular wall motion score index and ejection fraction were assessed. Delta SBP < 35 mmHg during ET was considered abnormal (SBC,1995).


RESULTS
No significant correlation was found between delta SBP and post-transplantation time, graft ischemic time, history of rejection, diltiazem dosage, oxygen uptake, ejection fraction, and wall motion score index (WMSI). Delta SBP was normal in 17 patients (Group I) and abnormal in 28 (Group II). Patients of both groups did not differ significantly in regard to clinical features and ET and DSE results.


CONCLUSIONS
Unlike other populations, no correlation was found between delta SBP during exercise testing and clinical condition or left ventricular function in heart transplant patients. Pathophysiological factors associated with delta SBP reduction during exercise testing remain unknown.
Salles
Ana Fátima
AF
EPM, Universidade Federal de São Paulo, São Paulo, SP, Brazil. asalles@cardiol.br
Machado
Cristiano Vieira
CV
Cordovil
Adriana
A
Leite
Wagner Aparecido
WA
Moisés
Valdir Ambrósio
VA
de Almeida
Dirceu Rodrigues
DR
Carvalho
Antonio Carlos Camargo
AC
Oliveira Filho
Japy Angelini
JA
D001794:Blood Pressure / Q000502:physiology*; D002316:Cardiotonic Agents; D004280:Dobutamine; D025401:Echocardiography, Stress; D005080:Exercise Test; D016027:Heart Transplantation / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013599:Systole / Q000502:physiology; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*
D002316:Cardiotonic Agents; D004280:Dobutamine