LAUSR

Objective: Central hemodynamics such as central pressures or pulse wave velocity are known to reflect arterial stiffness and can predict cardiovascular prognosis. It may change physiologically with age or pathologically in disorders. However, there are paucity of knowledge regarding central hemodynamics of heart transplant (HT) recipients. Design and method: We assessed central hemodynamics, using applanation tonometry (SphygmoCor, AtCor Medical) in 90 HT recipients. We analyzed differences in central hemodynamic parameters of HT recipients, compared with age- and sex-matched 90 hypertensive subjects (set 1: HT recipients + Hypertensive subjects) or 90 kidney transplant (KT) recipients (set 2: HT recipients + KT recipients) from Cardiovascular and Metabolic Diseases Etiology Research Center High Risk Cohort. Results: The median time after HT was 422 days (IQR, 45–1305 days). Central systolic pressure was not different, but central pulse pressure (CPP) and augmentation pressure (AP) were lower in HT compared to hypertensive subjects (CPP: 30.5 ± 9.9 vs 37.9 ± 9.2, p < 0.001; AP: 4.0 ± 5.3 vs 9.2 ± 6.8, p < 0.001) or KT recipients (CPP: vs 36.1 ± 4.3, p = 0.015; AP: vs 8.3 ± 7.5, p < 0.001). Pulse wave velocity was not different in HT recipients compared to other groups. After adjustment of age, gender, BMI, estimated glomerular filtration rate, diastolic blood pressure and antihypertensive agents, multivariable linear regression model showed HT was independent factor related to AP (set 1: p < 0.001; set 2: p = 0.010). In addition, HT was significantly associated with CPP (set 1: p = 0.001; set 2: p = 0.126). However, multivariable linear regression model including heart rate showed that HT was no longer independent factor for AP or CPP. Conclusions: AP and CPP were lower in HT recipients compared to age- and sex-matched hypertensive subjects or KT recipients. These differences of central hemodynamic parameters after HT might be attributed to increasing heart rate due to denervated heart. Further study for hemodynamic parameters after HT over the time should be needed.