title: Impact of basal heart rate on long-term prognosis of heart transplant patients.
abstract: Previous studies in patients with heart failure have shown that an elevated basal heart rate (HR) is associated with a poor outcome. Our aim with this study was to investigate if this relationship is also present in heart transplantation (HTx) recipients. From 2003 until 2010, 256 HTx performed in our center were recruited. Patients who required pacemaker, heart-lung transplants, pediatrics, retransplants, and those patients with a survival of less than 1 year were excluded. The final number included in the analysis was 191. Using the HR obtained by EKG during elective admission at 1 year post-HTx and the survival rate, an ROC-curve was performed. The best point under the curve was achieved with 101 beats per minute (bpm), so patients were divided in two groups according to their HR. A comparison between survival curves of both groups was performed (Kaplan-Meier). Subsequently, a multivariate analysis considering HR and other variables with influence on survival according to the literature was carried out. A total of 136 patients were included in the group with HR ≤100 bpm, and 55 in the one with HR >100 bpm. There were no basal differences in both groups except for primary graft failure, which was more frequent in the >100 bpm group (30.9 vs. 17%, P = 0.033). Patients with ≤100 bpm had a better long prognosis (P < 0.001). The multivariate analysis proved that high HR was an independent predictor of mortality. Our study shows that HR should be considered as a prognosis factor in HTx patients.
authors.affiliation: Unidad de Insuficiencia Cardíaca y Trasplante, Servicio de Cardiología, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain. josep.melero@gmail.com
authors.forename: Josep L
authors.initials: JL
authors.lastname: Melero-Ferrer
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Sánchez-Lázaro
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar-Bonet
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: Francisco
authors.initials: F
authors.lastname: Buendía-Fuentes
authors.forename: Manuel
authors.initials: M
authors.lastname: Portolés-Sanz
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivera-Otero
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador-Sanz
mesh_terms: D000328:Adult; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D016027:Heart Transplantation / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors