BACKGROUND: Renal transplantation improves left ventricular (LV) function, but cardiovascular mortality remains elevated. The aim of this cross-sectional study was to determine whether subclinical abnormalities of LV longitudinal function also persist in patients who underwent renal transplant in childhood. METHODS: Conventional and speckle tracking echocardiography was performed in 68 renal transplant recipients (34 children and 34 adults, median 9.8 years (range 2.0-28.4 years) after first transplantation and 68 age- and sex-matched healthy controls. RESULTS: Mean age at first transplantation was 8.8 ± 4.8 years. Forty-three percent had a pre-emptive transplant. Of the remaining, 70% received haemodialysis and 30% peritoneal dialysis on average for 6.9 months. Thirty-one percent of paediatric and 35% of adult patients had hypertension. LV mass index was increased in adult patients (92 ± 24 vs 75 ± 11 g/m(2), P< 0.01). LV diastolic function and exercise capacity were impaired in both paediatric and adult patients. LV longitudinal peak systolic strain and strain rate were comparable in patients and controls. In multivariate analysis, systolic blood pressure and LV diastolic relaxation were the main covariates of LV peak systolic strain and strain rate (all P < 0.01). CONCLUSIONS: Patients who underwent renal transplantation in childhood have abnormal LV diastolic function and impaired exercise capacity, despite preserved LV longitudinal systolic deformation.
BACKGROUND: Renal transplantation improves left ventricular (LV) function, but cardiovascular mortality remains elevated. The aim of this cross-sectional study was to determine whether subclinical abnormalities of LV longitudinal function also persist in patients who underwent renal transplant in childhood. METHODS: Conventional and speckle tracking echocardiography was performed in 68 renal transplant recipients (34 children and 34 adults, median 9.8 years (range 2.0-28.4 years) after first transplantation and 68 age- and sex-matched healthy controls. RESULTS: Mean age at first transplantation was 8.8 ± 4.8 years. Forty-three percent had a pre-emptive transplant. Of the remaining, 70% received haemodialysis and 30% peritoneal dialysis on average for 6.9 months. Thirty-one percent of paediatric and 35% of adult patients had hypertension. LV mass index was increased in adult patients (92 ± 24 vs 75 ± 11 g/m(2), P< 0.01). LV diastolic function and exercise capacity were impaired in both paediatric and adult patients. LV longitudinal peak systolic strain and strain rate were comparable in patients and controls. In multivariate analysis, systolic blood pressure and LV diastolic relaxation were the main covariates of LV peak systolic strain and strain rate (all P < 0.01). CONCLUSIONS:Patients who underwent renal transplantation in childhood have abnormal LV diastolic function and impaired exercise capacity, despite preserved LV longitudinal systolic deformation.
Authors: Benjamin W Eidem; Colin J McMahon; Radha R Cohen; Jin Wu; Irina Finkelshteyn; John P Kovalchin; Nancy A Ayres; Louis I Bezold; E O'Brian Smith; Ricardo H Pignatelli Journal: J Am Soc Echocardiogr Date: 2004-03 Impact factor: 5.251
Authors: Juan Manuel Guízar-Mendoza; Norma Amador-Licona; Efrén Edgard Lozada; Leticia Rodriguez; María Gutiérrez-Navarro; Luis Antonio Dubey-Ortega; José Trejo-Bellido; José de Jesús Encarnación; María De la Cruz Ruiz-Jaramillo Journal: Pediatr Nephrol Date: 2006-08-15 Impact factor: 3.714
Authors: Mark M Mitsnefes; Thomas R Kimball; William L Border; Sandra A Witt; Betty J Glascock; Philip R Khoury; Stephen R Daniels Journal: Kidney Int Date: 2004-04 Impact factor: 10.612
Authors: Joseph T Flynn; Mark Mitsnefes; Christopher Pierce; Steven R Cole; Rulan S Parekh; Susan L Furth; Bradley A Warady Journal: Hypertension Date: 2008-08-25 Impact factor: 10.190
Authors: Mark M Mitsnefes; Thomas R Kimball; William L Border; Sandra A Witt; Betty J Glascock; Philip R Khoury; Stephen R Daniels Journal: Am J Kidney Dis Date: 2004-04 Impact factor: 8.860
Authors: Philip T Levy; Aliza Machefsky; Aura A Sanchez; Meghna D Patel; Sarah Rogal; Susan Fowler; Lauren Yaeger; Angela Hardi; Mark R Holland; Aaron Hamvas; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2015-12-30 Impact factor: 5.251
Authors: Citlalli Osorio-Yáñez; Julio C Ayllon-Vergara; Laura Arreola-Mendoza; Guadalupe Aguilar-Madrid; Erika Hernández-Castellanos; Luz C Sánchez-Peña; Luz M Del Razo Journal: Environ Health Perspect Date: 2015-02-27 Impact factor: 9.031
Authors: Adrienn Bárczi; Bálint Károly Lakatos; Mónika Szilágyi; Éva Kis; Orsolya Cseprekál; Alexandra Fábián; Attila Kovács; Attila J Szabó; Béla Merkely; Paolo Salvi; György S Reusz Journal: Pediatr Nephrol Date: 2022-02-15 Impact factor: 3.651