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Long-term changes in left ventricular hypertrophy after renal transplantation
C Rigatto1, R N Foley, G M Kent
1Division of Nephrology, Memorial University, St. John's Newfoundland, Canada.
Transplantation
|September 6, 2000
Summary
Left ventricular hypertrophy regression after kidney transplant continues until year two, then stabilizes. Factors like older age and hypertension predict poor regression, impacting long-term cardiac health in transplant recipients.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Left ventricular hypertrophy (LVH) is a common, progressive complication in dialysis patients, linked to adverse cardiac outcomes.
- While partial LVH regression occurs post-transplant, its long-term trajectory remains unclear.
Purpose of the Study:
- To investigate the long-term evolution of left ventricular hypertrophy (LVH) after renal transplantation.
- To identify factors associated with the failure of LVH regression post-transplant.
Main Methods:
- A prospective cohort study of 143 renal transplant recipients from a larger dialysis patient cohort.
- Annual echocardiography and monthly laboratory assessments over four years post-transplant.
- Multiple linear regression analysis to model changes in left ventricular mass index (LVMI).
Main Results:
- LVMI decreased significantly from year 1 to year 2 post-transplant (161 g/m2 to 146 g/m2), then stabilized.
- Left ventricular volume index followed a similar pattern, declining by year 2 and stabilizing thereafter.
- Failure to regress LVMI by year 2 was associated with older age, hypertension, and specific pulse pressure characteristics relative to heart size.
Conclusions:
- LVH regression extends beyond the first year post-renal transplant, reaching a nadir at two years and persisting.
- Older age, history of hypertension, and abnormal pulse pressure dynamics are linked to incomplete LVH regression.