Abstract
Heart rate slowing agents are frequently prescribed to manage heart transplant (HTx) patients with the assumption that higher heart rate is a risk factor in cardiovascular disease. This prospective two-center study investigated early progression of cardiac allograft vasculopathy (CAV) in 116 HTx patients. Examinations by coronary optical coherence tomography and 24-hour ambulatory ECG monitoring were performed both at baseline (1month after HTx) and during follow-up (12months after HTx). During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area from 9.0±2.5 to 8.0±2.4 mm2 (P<.001), and progression in mean intimal thickness (IT) from 106.5±40.4 to 130.1±53.0µm (P<.001). No significant relationship was observed between baseline and follow-up mean heart rates and IT progression (R=.02, P=.83; R=-.13, P=.18). We found a mild inverse association between beta-blocker dosage at 12months and IT progression (R=-.20, P=.035). Our study did not confirm a direct association between mean heart rate and progression of CAV. The role of beta blockers warrants further investigation, with our results indicating that they may play a protective role in early CAV development.
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