Key result
High arterial stiffness (AIx > -5%) in heart transplant recipients was associated with longer time after transplantation (p=0.00) and higher HRV indices including SDNN (p=0.044) and LF/HF (p=0.034).
Cross-Sectional (n=35)
In heart transplant recipients, a longer time since transplantation is associated with increased arterial stiffness, which correlates with altered heart rate variability indices.
Findings should not change post-transplant monitoring; leaves open causal links between arterial stiffness and HRV requiring longitudinal studies.
BACKGROUND Arterial stiffness represented by Augmentation index (AIx) and heart rate variability (HRV) are established predictors of cardiovascular risk in heart transplant (HTx) recipients. However, the relationship between AIx and HRV in this population remains insufficiently explored, and factors such as time after transplantation may influence both metrics. OBJECTIVE The purpose of this study was to evaluate vascular function through Aix and HRV parameters in heart transplant patients, both assessed by peripheral arterial tonometry. METHODS A cross-sectional study was conducted with 35 adults aged 18-65 years, HTx ≥ six months after surgery, with stable clinical condition and no changes over the last three months of immunosuppressive treatment. AIx and HRV were assessed using peripheral arterial tonometry (PAT). RESULTS Participants were categorized into two groups based on AIx values: High AIx (n = 19, AIx > -5%) and Low AIx (n = 16, AIx ≤ -5%). The High AIx group had a significantly longer time after transplantation (p = 0.00). HRV analysis revealed that the standard deviation of all normal NN intervals (SDNN, p=0.044), and lower frequency to high frequency ratio (LF/HF, p=0.034) were significantly higher (p=0.03) and HR was significantly lower (p=0.04) in the High AIx group compared to Low AIx. CONCLUSION Arterial stiffness assessed by peripheral arterial tonometry was higher in patients with a longer time after heart transplantation. Similarly, HRV indices, which reflect several cardiovascular health conditions, such as SDNN and sympathovagal balance (LF/HF ratio) were higher in the group with higher arterial stiffness in individuals after heart transplantation.
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Souza et al. (2025) conducted a cross-sectional in heart transplant (n=35). High arterial stiffness (AIx > -5%) vs. Low arterial stiffness (AIx ≤ -5%) was evaluated on Time after transplantation and heart rate variability (HRV) parameters (p=0.00). High arterial stiffness (AIx > -5%) in heart transplant recipients was associated with longer time after transplantation (p=0.00) and higher HRV indices including SDNN (p=0.044) and LF/HF (p=0.034).
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