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Left ventricular hypertrophy in renal transplant recipients in the first year after transplantation
K Slubowska1, B Lichodziejewska2, P Pruszczyk2
1Department of Transplantation Medicine and Nephrology, Transplantation Institute, Warsaw Medical University, Warszawa, Poland.
Insights
Left ventricular hypertrophy (LVH) affects half of renal transplant recipients within a year. Echocardiography and NT-proBNP levels aid in diagnosing LVH and related cardiac changes post-transplant.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Left ventricular hypertrophy (LVH) is a critical risk factor for cardiovascular complications in patients who have received a kidney transplant.
- Assessing LVH and its associated factors within the first year post-transplantation is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the prevalence of left ventricular hypertrophy (LVH) in renal transplant recipients during the first year after transplantation.
- To identify factors influencing LVH development, regression, and persistence in this patient cohort.
Main Methods:
- Echocardiographic examinations were conducted in 43 patients early post-transplant and 40 patients at 1-year follow-up.
- Basic blood tests, N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, and ambulatory blood pressure monitoring were performed.
- Left ventricular mass index was used to diagnose LVH, with specific thresholds for men and women.
Main Results:
- LVH was present in approximately 50% of patients both early post-transplant and at 1 year.
- Weight gain hindered LVH regression, while poor blood pressure control contributed to new-onset LVH.
- Higher NT-proBNP levels were associated with the presence of LVH, and concentric remodeling was observed in patients without LVH.
Conclusions:
- Half of renal transplant recipients exhibit LVH within the first year, with the remainder showing concentric remodeling.
- Echocardiographic assessment is recommended for all renal transplant recipients.
- NT-proBNP measurements are valuable tools for diagnosing LVH in this population.
Background:
Left ventricular hypertrophy (LVH) is a significant risk factor for cardiovascular complications in renal transplant recipients. The study objective here was to assess LVH and related factors in renal transplant recipients in the 1st year after transplantation.
Methods:
Echocardiographic examinations were performed in the early post-transplantation period in 43 patients (age, 43.9 ± 12.4 years; male, 53.5%) and at 1 year after transplantation in 40 patients. At the same time, basic blood tests, N-terminal pro-B-type natriuretic peptide (NT-proBNP) level tests, and ambulatory blood pressure measurements were performed. LVH was diagnosed when LV mass index was >95 g/m(2) in women and >115 g/m(2) in men. Statistical analyses were performed with the use of the R Package.
Results:
LVH (mainly concentric) was found in 51.2% of the patients in the early period and in 50% of the patients at 1 year. In 30% of the patients with baseline LVH it regressed at 1 year and in another 30% LVH developed de novo. In the early period, LV mass was influenced by age, sex, body mass index (BMI), estimated glomerular filtration rate (eGFR), and a history of cardiovascular disorders during dialysis therapy, whereas at 1 year after transplantation it was influenced by age, sex, BMI, 24-hour systolic blood pressure, a history of hypertension during dialysis therapy, and abnormal 24-hour blood pressure profile. Weight gain interfered with LVH regression during the 1st year after transplantation, whereas no improvement in blood pressure control contributed to de novo development of LVH. All other patients (those without LVH) had a morphologic abnormality of the left ventricle, the so-called concentric remodeling. Higher NT-proBNP levels were observed in patients with LVH.
Conclusions:
LVH is present in one-half of renal transplant recipients in the 1st year after transplantation, and concentric remodeling is present in the remaining patients of this group. An echocardiographic examination is indicated in every renal transplant recipient. Measurements of NT-proBNP levels are helpful in LVH diagnostics.
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