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Ventricular arrhythmia in incident kidney transplant recipients: prevalence and associated factors
Aline P Marcassi1, Daniel C Yasbek, Jose Osmar Medina Pestana
1Nephrology Division, Federal University of São Paulo, São Paulo, Brazil.
Insights
Kidney transplant recipients have high rates of ventricular arrhythmia (VA), a cause of sudden death. Male gender and coronary artery calcification (CAC) are linked to VA in these patients.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Kidney transplant recipients face elevated cardiovascular mortality, especially within the first year post-transplant.
- Complex ventricular arrhythmias (VA) are a significant cause of sudden cardiac death in this population.
- Understanding VA prevalence and associated factors is crucial for risk stratification and management.
Purpose of the Study:
- To determine the prevalence of ventricular arrhythmias (VA) in incident kidney transplant recipients.
- To identify clinical and imaging factors associated with the occurrence of VA.
- To investigate the relationship between VA and cardiovascular risk markers.
Main Methods:
- A cohort of 100 incident kidney transplant recipients underwent 24-hour electrocardiogram, echocardiogram, and multi-slice computed tomography.
- Prevalence of VA was assessed.
- Factors including left ventricular hypertrophy, heart failure, and coronary artery calcification (CAC) were evaluated.
Main Results:
- Thirty percent of kidney transplant recipients presented with VA.
- Left ventricular hypertrophy was found in 57% and heart failure in 5% of patients.
- Patients with VA were more likely to be male, have longer dialysis duration, and exhibit greater coronary artery calcification (CAC).
- Male gender and higher CAC score were independently associated with VA presence.
Conclusions:
- Kidney transplant recipients demonstrate a high prevalence of ventricular arrhythmias (VA).
- Male gender and coronary artery calcification (CAC) are significant independent predictors of VA in this cohort.
- These findings highlight the importance of cardiovascular risk assessment in kidney transplant recipients.
Abstract:
Cardiovascular mortality in kidney transplant recipients has shown to be substantially elevated particularly in the first year of transplantation. Complex ventricular arrhythmia (VA) has been pointed as one of the etiologies of sudden death. The aim of this study was to evaluate the prevalence of VA and to investigate the factors associated with their occurrence in incident kidney transplant recipients. A total of 100 incident kidney transplant recipients were included in the study (39.7 ± 10.1 years, 55% male, 43.6 ± 10.1 days of transplantation, 66% living donors). All the patients underwent 24 h electrocardiogram, echocardiogram and multi-slice computed tomography. Thirty percent of the patients had VA. Left ventricular hypertrophy was observed in 57% of the patients while heart failure was found in 5%. Coronary artery calcification (CAC) was observed in 26 patients, from which 31% had severe calcification. The group of patients with VA was predominantly male, had been on dialysis therapy for a longer time and had more coronary calcification. In the multiple logistic regression analysis, male gender and CAC score were independently associated with the presence of VA. In conclusion, kidney transplant recipients exhibited a high prevalence of VA and the factors associated with its occurrence were the male gender and the presence of CAC.
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