Physiotherapy Service, Instituto Nacional de Cardiologia, Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Physiological Sciences, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Braz J Cardiovasc Surg. 2022 Aug 16;37(4):454-465. doi: 10.21470/1678-9741-2021-0083.
Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients.
This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05.
Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL.
This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.
心脏移植（HT）受者的自主神经系统（ANS）对心率的控制受损，导致静息心率、代谢需求和疲劳增加，从而损害其生活质量（QoL）。在这项研究中，我们假设血液动力学和自主功能的关联是 HT 受者 QoL 的预测因子。
这是一项横断面研究，在门诊陪同下对年龄≥18 岁的 HT 受者进行。血压用于血液动力学评估，心率变异性（HRV）用于 ANS 评估。使用 36 项简短健康调查问卷评估 QoL。显著性水平设定为 P≤0.05。
共纳入 22 名志愿者进行研究。收缩压（SBP）和双乘积（DP）与 QoL 的身体机能域呈显著负相关。DP、连续正常 RR 间隔差异>50ms 的数量（NN50）和正常 RR 间隔与相邻间隔相差>50ms 的百分比（PNN50）与身体疼痛、社会功能和情绪角色域呈负相关。NN50 和 PNN50 与身体疼痛、社会功能和情绪角色域显著相关。SBP 与活力域呈负相关。考虑到一般和心理健康领域，没有变量表现出显著的相关性。DP、NN50 和 PNN50 与 QoL 的总分呈负相关。
本研究表明 DP 和 HRV 是 HT 受者 QoL 的预测因子。这些创新性的结果可以成为改善 HT 受者 QoL 的相关治疗靶点，以防止其恶化。
