048 Does heart rate predict coronary allograft vasculopathy and coronary events in heart transplant recipients?

Previous studies have shown that heart rate is a predictor of coronary events and cardiovascular mortality. Moreover, pathophysiological studies indicate that a relatively high heart rate has detrimental effects on the progression of coronary atherosclerosis. Heart transplant recipients frequently have sinus tachycardia related to cardiac denervation. Therefore we evaluated the prognostic importance of heart rate in heart transplant recipients.143 consecutive heart transplant recipients (age at transplantation: 48.5±13 years) with at least a 2 year survival after transplantation were studied with a 9.5 year mean follow-up (range 2-23 years). Basal heart rate was measured at rest 3 months after heart transplantation in the absence of beta-blocker therapy or acute rejection. Survival without cardiac event was compared between patients with basal heart rate < or >95/min (median) according to Kaplan-Meier method using log-rank test.Fifty-six patients had coronary irregularities or stenoses at routine biennal coronary angiography and 87 had angiographically normal coronary arteries during the follow-up. Mean basal heart rate did not significantly differ between these two groups (96.4/min vs 98.3/min p=0.34). Twenty-seven patients had a coronary event (myocardial infarction, percutaneous coronary intervention or coronary death). Survival without coronary event did not significantly differ between patients with basal heart rate > or < 95/min (logrank p= 0,97).ConclusionThis series does not support a prognostic influence of heart rate for cardiac allograft vasculopathy or coronary events in heart transplant recipients.