Renal transplantation was associated with a reduction in left ventricular mass index from 161 g/m2 at 1 year to 146 g/m2 at 2 years (P=0.009), with stabilization in years 3 and 4.
Cohort (n=143)
Does renal transplantation improve left ventricular hypertrophy over the long term in dialysis patients?
Regression of left ventricular hypertrophy continues up to 2 years after renal transplantation and then stabilizes, with older age and hypertension predicting failure to regress.
Absolute Event Rate: 146% vs 161%
p-value: p=0.009
BACKGROUND: Concentric and eccentric left ventricular hypertrophy are common progressive disorders in dialysis patients and are associated with cardiac failure and death. Although partial regression of these abnormalities is known to occur during the first post-transplant year, their long-term evolution is unknown. METHODS: A total of 143 of 433 dialysis patients participating in a long-term prospective cohort study received renal transplants. Laboratory parameters were assessed monthly. Echocardiography was performed annually. Left ventricular mass index (LVMI) and cavity volume index were calculated according to standard formulae. Multiple linear regression was used to model change in LVMI as a function of baseline clinical and laboratory variables. RESULTS: LVMI fell from 161 g/m2 at 1 year to 146 g/m2 (P=0.009) g/m2 after 2 years. No further regression was seen in years 3 and 4. Left ventricular volume index showed similar trends, with a decline from year 1 to year 2 (P=0.05) followed by stabilization in years 3 and 4. Older age, long duration of hypertension, need for more than one antihypertensive, high pulse pressure in normal-size hearts, and low pulse pressure in dilated hearts were significantly associated with failure of regression of LVMI between the first and second years (MLR, P<0.000001, r2=0.57). CONCLUSIONS: Regression of left ventricular hypertrophy continues beyond the first year after renal transplantation, reaching a nadir at 2 years and persisting into the third and fourth posttransplant years. Failure to regress was associated with older age, hypertension, high pulse pressure in normal-size hearts and low pulse pressure in dilated hearts.
Rigatto et al. (Tue,) conducted a cohort in Left ventricular hypertrophy in dialysis patients (n=143). Renal transplantation vs. 1 year post-transplant (baseline for comparison) was evaluated on Left ventricular mass index (LVMI) (p=0.009). Renal transplantation was associated with a reduction in left ventricular mass index from 161 g/m2 at 1 year to 146 g/m2 at 2 years (P=0.009), with stabilization in years 3 and 4.