Kidney transplantation in patients with ventricular ejection fraction less than 50 percent: features and posttransplant outcome

Melchor, J.L; Espinoza, R; Gracida, C

doi:10.1016/s0041-1345(02)03478-4

Cited by 32 publications

(28 citation statements)

References 3 publications

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“…Improvement of LV systolic function (as determined by LVEF assessment) after KTX was shown in patients with moderately reduced LV systolic function and occurs within a relatively short-term follow-up after KTX [5,28]. In the present study, most patients had preserved or mildly impaired LVEF before KTX, which might explain why we observed only a slight, non-significant increase in LVEF.…”

Section: Discussionmentioning

confidence: 38%

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

Hewing

Dehn

Staeck

et al. 2016

Kidney Blood Press Res

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Background/Aims: Cardiac changes observed in chronic kidney disease patients are of multifactorial origin including chronic uremia, hemodynamics or inflammation. Restoration of renal function by kidney transplantation (KTX) may reverse cardiac changes. Novel echocardiographic methods such as speckle tracking echocardiography (STE) allow early and sensitive detection of subtle changes of cardiac parameters. We evaluated changes of cardiac structure and function after KTX by advanced echocardiographic modalities. Methods: Thirty-one KTX recipients (female n=11) were evaluated by medical examination, laboratory testing and echocardiography before and after KTX (median follow-up 19 months). Left ventricular (LV) and right ventricular (RV) diameters and function were assessed by echocardiographic standard parameters. Longitudinal 2D strain of the LV (GLPS) and left atrium (LA) was determined by 2D STE. Results: After KTX, median serum creatinine level was 1.3 mg/dl (IQR, 1.2-1.5). Systolic blood pressure decreased significantly after KTX. Echocardiography showed a significant reduction in LV end-diastolic septal and posterior wall thickness and LV mass index after KTX, which was accompanied by an improvement of GLPS. There were no relevant changes in parameters of LA (reservoir, conduit or contractile) function, LV diastolic or RV function after KTX. Conclusion: LV hypertrophy reversed after successful KTX and was accompanied by an improvement in longitudinal LV function as assessed by STE. Diastolic function and STE-derived LA function parameters did not change significantly after KTX.

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Section: Discussionmentioning

confidence: 38%

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

Hewing

Dehn

Staeck

et al. 2016

Kidney Blood Press Res

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show abstract

“…KDOQI guidelines recommend that patients should be evaluated with an echocardiogram at the initiation of dialysis once dry weight is achieved, ideally 1 to 3 months after the initiation of dialysis, and at 3‐year intervals thereafter24 to assess LVEF, structural abnormalities, and valvular disease 20. Although many studies have demonstrated that patients with low LVEF can safely undergo renal transplantation7, 92, 96—most notably, a report of 11 patients with LVEF ≤20%7—there is currently no consensus regarding the minimum LVEF required to safely undergo renal transplantation.…”

Section: Chf In Patients With Esrdmentioning

confidence: 99%

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

Bhatti

Galougahi

Paz

et al. 2016

JAHA

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“…The data from the literature suggest that the greatest benefit of RT in relation to the LV systolic function refers to patients with very impaired contractility. Melchior et al [29] investigated a group of 29 patients with low EF and showed an increase of the average EF from 37.8% to the value of almost normal, as much as 52% over the short, because only 1-month follow-up. Further observation showed further improvements in contractility, because after a year of follow-up EF was already 58.2%.…”

Section: Discussionmentioning

confidence: 99%

The reverse remodeling of the aorta in patients after renal transplantation - the value of aortic stiffness index: prospective echocardiographic study

et al. 2017

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BackgroundAtherosclerosis is regarded as a combination of two major separate diseases: atherosis and sclerosis. Sclerotic component depends on deterioration of elastic properties of the aortic wall and is called aortic stiffness. The most valuable, non-invasive method of aortic stiffness assessment is echocardiography, which allows to calculate the aortic stiffness index (ASI). ASI is an independent predictor of all-cause and cardiovascular mortality in different groups of patients. The main aim of study was the assessment of the aortic reverse remodeling in patients with end-stage renal disease (ESRD) after renal transplantation (RT).MethodsStudy group involved 42 patients aged 43.3 ± 12.6 years, including 19 women aged 49.9 ± 10.9 years and 23 men aged 41.5 ± 12.91 years, who have undergone RT from non-related renal transplant donors, The study protocol has been consisted of 5 stages: 1 week after RT, 3 months after RT, 6 months after RT, 1 year after RT and 3 years after RT. The echocardiographic examination was performed and measurements of Aomax, Aomin were done. On the base of obtained parameters ASI, aortic distensibility (AD) and aortic strain (AS) were calculated according to adequate formulas.ResultsThe improvement of indices characterizing the elastic properties of aorta were noted. These changes attained the statistically significant level only at the end of the observation. ASI just after RT was equal – 4.65 ± 1.58, three months after RT – 4.54 ± 1.49, six months after RT – 4.59 ± 1.61, one year after RT – 4.35 ± 1.21 and three years after RT – 3.35 ± 1.29, while AD reached respectively – 6.55 ± 3.76 cm2/dyn−110−6 just after RT, − 6.38 ± 3.42 cm2/dyn−110−6 three months after RT, − 6.53 ± 3.60 cm2/dyn−110−6 six months after RT, − 6.48 ± 2.79 cm2/dyn−110−6 one year after RT and – 8.03 ± 3.95 cm2/dyn−110−6 three years after RT. Noted AS values were equal – 6.61 ± 4.05%, just after RT, − 6.40 ± 3.58% three months after RT, − 6.56 ± 3.76%, six months after RT, − 6.45 ± 2.80% one year after RT, − 8.01 ± 3.97%. and three years after RT. The exact analysis of parameters concerning aortic function showed that to achieve ASI, AD and AS improvement, long time was needed, because the most significant changes of these indices were observed only between 1 year and 3 years after RT.ConclusionsThere is a relationship between renal transplantation and improvement of the aortic elastic properties. The recovery of the renal function allows to initiate the reparative processes leading to at least partial restitution of the structure and features of the aorta, which is called reverse remodelling. Improvement of aortic wall elastic properties after renal transplantation is a continuous and prolonged process.

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Kidney transplantation in patients with ventricular ejection fraction less than 50 percent: features and posttransplant outcome

Cited by 32 publications

References 3 publications

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

Improved Left Ventricular Structure and Function After Successful Kidney Transplantation

Diagnosis and Management of Cardiovascular Disease in Advanced and End‐Stage Renal Disease

The reverse remodeling of the aorta in patients after renal transplantation - the value of aortic stiffness index: prospective echocardiographic study

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