Key result
Regression of initially enlarged left atrial diameter after kidney transplantation was associated with a significantly lower risk of overall mortality (HR 0.45; 95% CI 0.30-0.69; P<0.001).
Why the study?
Is regression of left atrial diameter after kidney transplantation associated with reduced overall and cardiovascular mortality?
Observational (n=414)
Is regression of left atrial diameter after kidney transplantation associated with reduced overall and cardiovascular mortality?
Effect estimate: HR 0.45 (95% CI 0.30-0.69)
p-value: p=< 0.001
Regression of left atrial diameter after kidney transplantation is associated with a significantly lower risk of overall and cardiovascular mortality.
LA diameter regression after kidney transplant was associated with lower mortality; hypothesis-generating, requiring prospective confirmation before clinical use.
Renal transplantation reduces the dramatically elevated risk of cardiovascular death in dialysis patients. We previously showed that left atrial diameter before transplantation predicts cardiovascular and overall mortality. Now, we investigated the association of changes in cardiac morphology after transplantation and mortality. We retrospectively analyzed data from the Austrian transplant repository using multivariable Cox and competing risk models and multivariable logistic regression for the prediction of changes in cardiac morphology. We identified 414 patients with a median follow-up of 8 years and observed a significant progression of mean diameter of left atrium (LA), right atrium and right ventricle and a significant regression of left ventricle. Complete case analysis of 243 patients with a regression of initially enlarged LA diameter had a significantly lower risk of adjusted overall and cardiovascular mortality; hazard ratio (HR 0.45, 95% CI 0.30-0.69, P < 0.001, 124 deaths), and HR of 0.43 [95% CI 0.21-0.92, P = 0.029, 48 cardiovascular (CV) deaths], respectively. Only age at transplantation was significantly associated with regression of LA (OR 0.75, 95% CI 0.60-0.93, P = 0.007). Patients with regression of LA after kidney transplantation exhibited a lower overall and CV mortality risk. Besides age, peritoneal dialysis and antihypertensive therapy were mediators of LA regression.
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Regele et al. (2018) conducted an observational in Kidney transplantation (n=414). Regression of left atrial diameter vs. No regression of left atrial diameter was evaluated on Overall mortality (HR 0.45, 95% CI 0.30-0.69, p=< 0.001). Regression of initially enlarged left atrial diameter after kidney transplantation was associated with a significantly lower risk of overall mortality (HR 0.45; 95% CI 0.30-0.69; P<0.001).
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