Heart rate variability arterial hypertension in young heart-transplanted recipients: association progression of cardiac allograft vasculopathy?

Pediatr Transplant. 2013 Aug;17(5):441-4. doi: 10.1111/petr.12105. Epub 2013 Jun 5.

Abstract

Hypertension and reduced HRV are frequent in heart-transplanted recipients. We studied 26 young recipients to investigate the relationship between BP and HRV during simultaneous 24-h monitoring. Presence of CAV was considered. All HRV measures were significantly lower than normal values. Significant correlations were found between mean daytime systolic BP and the rMSSD (p = 0.04), and mean daytime DBP and SDANN for all 5-min segments (p = 0.03) and between rMSSD and mean nighttime DBP (p = 0.03). Four patients were hypertensive during daytime, seven had a reduced nocturnal fall and two had a nocturnal rise in BP. Eight patients showed severe CAV grade (grade IV) on the Stanford scale, 13 moderate (grade III) and five mild (grade I-II). After a follow-up time of 30 months, four of the 13 patients (30%) with CAV grade III showed an increase to grade IV and all showed abnormalities of both HRV and ABPM patterns. The relationship between HRV abnormalities and arterial hypertension and CAV should be further explored.

Keywords: heart rate variability; hypertension; pediatric heart transplant.

MeSH terms

  • Adolescent
  • Adult
  • Allografts
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Cardiac Catheterization
  • Child
  • Circadian Rhythm / physiology
  • Disease Progression
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart / physiopathology
  • Heart Rate*
  • Heart Transplantation / methods*
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / physiopathology*
  • Male
  • Monitoring, Physiologic / methods
  • Young Adult