Elevated Heart Rate Following Heart Transplantation Is Associated With Increased Graft Vasculopathy and Mortality

Max Liebo, Joshua Newman, Anjali Joshi, Brian D. Lowes, Yael Peled-Potashnik, Haseeb Ilias Basha, Ronald Zolty, John Y. Um, Edwin McGee, Alain Heroux, Eugenia Raichlin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The effect of elevated heart rate (HR) on outcomes after heart transplantation (HT) has not been well established. The aim of this study was to assess predictors of elevated HR following HT and its impact on outcomes. Methods and Results: We retrospectively evaluated 394 patients who underwent HT at 2 academic medical centers from 2005 to 2016. Patients were divided into 2 groups based on HR 1 year after HT: HR ≥95 beats/min (n = 162; 41%) and HR <95 beats/min (n = 232; 59%). Median follow-up time was 6.6 (interquartile range [IQR] 2.2–7.5) years. HR ≥95 beats/min 1 year after HT was associated with younger donor age, whereas HR <95 beats/min was associated with heavy donor alcohol use and African-American recipient race. Left ventricular (LV) end-diastolic dimension, mass, and ejection fraction were lower and E/E′ higher in the HR ≥95 group at the time of the last follow up. HR ≥95 beats/min at 1 year after HT was independently associated with the development of cardiac allograft vasculopathy and increased mortality. Conclusions: HR ≥95 beats/min 1 year after HT is associated with a reduction in LV size and function, increased incidence of cardiac allograft vasculopathy, and reduced survival. Studies investigating the effect of medical HR reduction on post-HT outcomes are warranted.

Original languageEnglish
Pages (from-to)249-256
Number of pages8
JournalJournal of Cardiac Failure
Issue number4
StatePublished - Apr 2019
Externally publishedYes


  • cardiac allograft vasculopathy
  • heart rate
  • heart transplant
  • survival


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