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Changes in Left Ventricular Mass and Cardiovascular Risk Factors after Kidney Transplantation
Sandeep Sreedharan1, Anil Mathew1, Zachariah Paul1
1Department of Nephrology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
Insights
Kidney transplantation significantly reduces left ventricular hypertrophy (LVH) and improves heart function in recipients. This study provides the first Indian data showing renal transplants improve cardiovascular risk factors.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Left ventricular hypertrophy (LVH) is a major cause of sudden cardiac death and a common complication post-transplant.
- Limited data exists from India on cardiovascular changes after kidney transplantation.
- Assessing LVH and cardiac function is crucial for improving outcomes in renal transplant recipients.
Purpose of the Study:
- To investigate changes in left ventricular mass and cardiac function in kidney transplant recipients.
- To evaluate the impact of kidney transplantation on cardiovascular risk factors.
- To provide data from India on post-transplant cardiovascular changes.
Main Methods:
- Prospective observational study including kidney transplant recipients.
- Echocardiography and clinical/biochemical parameters measured pre-transplant, at 6 months, and 1 year.
- Analysis focused on left ventricular mass index, ejection fraction, and blood pressure control.
Main Results:
- Significant reduction in left ventricular mass index (LVMI) from 124.8 ± 39 to 102.2 ± 24.4 g/m² (P <0.001).
- Improvement in ejection fraction from 57.8 ± 7% to 60.1 ± 1.9% (P = 0.015) at six months.
- Significant improvements in hemoglobin, blood pressure control, and reduced need for antihypertensive medications.
Conclusions:
- Kidney transplantation leads to significant regression of left ventricular hypertrophy.
- Renal transplantation improves both systolic and diastolic cardiac function.
- Transplantation effectively ameliorates cardiovascular risk in kidney transplant recipients.
Abstract:
Left ventricular hypertrophy (LVH), the most common structural cardiac complication, is the single most important cause for sudden cardiac death. There are no published data from India looking at the changes in left ventricular mass and cardiac dysfunction after kidney transplantation. We aimed to determine the changes in the left ventricular mass and other cardiovascular risk factors in kidney transplant recipients. This was a prospective observational study. All patients who underwent kidney transplantation at Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, during the study period were included in the study. Measurement of clinical and biochemical parameters and echocardiography were done before, six months, and one year after transplantation. There was significant reduction in LV mass index (124.8 ± 39 vs. 102.2 ± 24.4 g/m2, P <0.001) and improvement in ejection fraction (57.8 ± 7 vs. 60.1 ± 1.9, P = 0.015) at the end of six months. There were significant differences in the mean hemoglobin, systolic, and diastolic blood pressures (P <0.001) during the study. There was also a significant reduction in the number of antihypertensive drugs required for blood pressure control. There was a significant reduction in LVH in the study group. There was also improvement in systolic and diastolic functions of the heart. There was also a significant improvement in blood pressure control both in terms of mean blood pressure levels as well as in terms of the number of anti-hypertensive drugs needed for blood pressure control. Renal transplantation ameliorates cardiovascular risk in renal transplant recipients.
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