Introduction: Hypertension is a common complication following paediatric heart transplantation. One potential important factor is arterial stiffness, which has been shown to increase the risk of cardiovascular disease in adults.

Aim: To compare measures of arterial stiffness between paediatric heart transplant recipients (HTR) and healthy children.

Methods: Height, weight and blood pressure were measured in 191 healthy children (5–15 years) and 27 HTR (ages 6–18 years). Peripheral pulses were recorded at the ears, fingers and toes using multi-site photoplethysmography technology. Pulse transit times (PTT) and their differences between sites were calculated as indicators of arterial stiffness. ANCOVA statistical analysis was used to assess differences between the subject groups.

Results: ANCOVA analysis, with adjustments for differences in physical variables, demonstrated that measurements were significantly shorter in the HTR compared to normals for absolute toe PTT (300 ms vs. 312 ms, p=0.009) and the differences in toe PTT compared with ear (150 ms vs. 177 ms, p<0.001) and finger (101 ms vs. 121 ms, p<0.001). In addition, this study also found that HTR had significantly higher diastolic blood pressure (DBP) (69 mmHg vs. 63 mmHg, p=0.034) and heart rates (91 bpm vs. 78 bpm, p=0.001).

Conclusion: This study shows that heart transplant recipients have significantly shorter PTT than normal subjects. This suggests they have stiffer arteries, which probably contributes to their systolic hypertension. When considered alongside differences in DBP, it would appear that hypertension in HTR is multi-factorial.