Usefulness of Heart Rate as an Independent Predictor for Survival After Heart Transplantation
| Autor: | C.L. Yau, Hector O. Ventura, Leann Myers, Rohit R. Amin, Paul F. Stahls, Debbie Dumas, Madhavi T. Reddy, Edward D. Frohlich, Rishi G. Anand |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate Risk Assessment Sensitivity and Specificity Cohort Studies chemistry.chemical_compound Postoperative Complications Sex Factors Heart Rate Cause of Death Internal medicine Heart rate Confidence Intervals Humans Medicine Monitoring Physiologic Retrospective Studies Cause of death Postoperative Care Heart transplantation Creatinine Ejection fraction business.industry Hazard ratio Age Factors Middle Aged Prognosis Survival Analysis Transplantation Blood pressure chemistry Multivariate Analysis Linear Models Cardiology Heart Transplantation Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 103:1290-1294 |
| ISSN: | 0002-9149 |
| Popis: | It was unclear whether increased heart rate (HR) increased long-term mortality after heart transplantation (HT). The aim of this study was to evaluate whether HR predicted survival after HT. A retrospective analysis of patients who underwent HT at our institution was performed. Ethnicity, gender, date of birth, age at transplantation, length of follow-up after transplantation, cardiac rhythm within 3 months after transplantation, age at death, reason for transplantation, cause of death, and baseline medications after transplantation were recorded. Continuous variables, such as HR, blood pressure, cardiac ejection fraction, presence of allograft vasculopathy, and serum creatinine, were recorded at3 months, 6 months, and 1 year after HT, then annually to 10 years after HT. Seventy-eight patients with a mean age of 50 +/- 13 years were identified. Mean survival was 8.5 +/- 6.5 years. Of 78 patients, 32 patients had an HRor=90 beats/min, and 46 patients had an HR90 beats/min within 3 months after HT. There was a mean decrease in HR of 6 beats/min during 10 years (p0.03). Multivariate survival analysis showed that HR90 beats/min was a significant predictor of early mortality (hazard ratio 2.8, 95% confidence interval 1.5 to 5.1, p0.0013). Patients with a net increase in HR during 10 years had an increased risk of death compared with patients with no change or a net decrease in HR (hazard ratio 4.7, 95% confidence interval 1.9 to 12.0, p0.002). No significant differences in cause of death between patients with an HRor=90 or90 beats/min existed. In conclusion, HT patients with an HR90 beats/min within the first 3 months after HT were 2.8 times more likely to die than patients with an HRor=90 beats/min. Patients with a net increase in HR were 4.7 times more likely to die than those whose HR did not change or decreased over time. |
| Databáze: | OpenAIRE |
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