Pre-operative echocardiographic abnormalities and adverse outcome following renal transplantation

McGregor, E.; Jardine, Alan G.; Murray, Lilian S.; Dargie, Henry J.; Rodger, R. S. C.; Junor, B. J. R.; McMillan, Margaret; Briggs, J. D.

doi:10.1093/ndt/13.6.1499

Cited by 77 publications

(72 citation statements)

References 14 publications

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“…In the present study, in the male and female, there is no significant difference in prevalence of LVH, which is comparable with a study of 141 pretransplant patients in which McGregor et al [16] found prevalence of LVH in 64-70% of males and 63-65% of females, but the result is opposite to the study P Dangri et al [17] suggesting that prevalence of LV hypertrophy was more in females. The results being same as the studyDeveroux et al [18] Left ventricular hypertrophy is the single strongest independent predictor of adverse cardiovascular events.…”

Section: Discussionsupporting

confidence: 78%

Echocardiographic Assessment of Left Ventricular Systolic Dysfunction in Chronic Kidney Disease Patients of a Rural Tertiary Medical Care Centre in West Bengal

Debnath¹,

Chaudhury²,

Chaturvedi³

et al. 2014

IOSRJDMS

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Section: Discussionsupporting

confidence: 78%

Echocardiographic Assessment of Left Ventricular Systolic Dysfunction in Chronic Kidney Disease Patients of a Rural Tertiary Medical Care Centre in West Bengal

Debnath¹,

Chaudhury²,

Chaturvedi³

et al. 2014

IOSRJDMS

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“…By and large these studies have shown that LV mass decreases posttransplantation and that this decrease parallels posttransplant improvement in BP control (8 -18). Two studies have suggested that pretransplant LVH is predictive of posttransplant mortality in the first 5 yr, but none have had sufficient power and long enough follow-up to examine whether posttransplant persistence or development of LVH are predictive of death and cardiovascular events (21,22). We have previously shown that CHF appears to be more frequent in RTR than in the general population and is independently associated with a twofold increased risk of death.…”

Section: Discussionmentioning

confidence: 97%

Electrocardiographic Left Ventricular Hypertrophy in Renal Transplant Recipients

Rigatto

Foley

Jeffery³

et al. 2003

Journal of the American Society of Nephrology

180

112

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Abstract. Left ventricular hypertrophy (LVH) is an independent risk factor for death and cardiovascular disease in the general population and dialysis patients. However, the causes and consequences of LVH have not been well described in renal transplant recipients (RTR). A retrolective cohort study was conducted in 473 RTR who were alive and free of cardiac disease at 1 yr. LVH was defined using the Cornell electrocardiographic (EKG) criteria. A total of 416 patients had an interpretable first-year EKG (88%), and 284 had an interpretable fifth-year EKG (78% of 5-yr survivors). Baseline characteristics were similar in patients with and without EKG. Of 416 patients, 57 had LVH in the first year, whereas 38 of 284 patients had LVH in the fifth year, of which 18 cases were de novo. Baseline LVH was a risk factor for death (RR 1.9 [1.22, 3.22]) and congestive heart failure (CHF) (RR 2.27 [1.08, 4.81]) and was independent of other major prognostic variables. Persistent or de novo LVH in the fifth year predicted subsequent death (RR 2.15 [1.14,4.01]) and CHF (2.71 [1.17,6.30]). Anemia and diastolic BP were independent risk factors for increasing Cornell voltage (a marker of LV mass) between first and fifth years. Systolic BP was the only predictor of de novo LVH at 5 yr. It seems that EKG LVH is a significant risk factor for death and CHF in RTR and that anemia and hypertension are risk factors for LV growth. Whether aggressive treatment of hypertension and anemia can improve outcomes merits further study.Left ventricular hypertrophy (LVH) is a well-established marker of cardiovascular risk in the general population. Both electrocardiographic (EKG) and echocardiographic (echo) LVH are strong independent predictors of outcome (1,2). EKG and echo have a similar specificity for LVH, but EKG is less sensitive for mild to moderate degrees of hypertrophy (3,4). Electrocardiography is much cheaper and more widely available than echo, however, making it a useful prognostic and epidemiologic tool.In dialysis patients, echo LVH has been shown to predispose to death and congestive heart failure (CHF) (5). The prevalence of echo LVH increases progressively with progression of renal insufficiency (5,6,7). Hypertension and chronic anemia appear to be the dominant stimuli for left ventricular growth in renal failure patients, although age, diabetes, and metabolic factors may also play a role (5,7). In renal transplant recipients, relatively little is known about the causes and consequences of LVH. Most studies have simply documented changes in echo LVH before and after transplantation or in the first few posttransplant years (8 -18). Neither the causes of LVH nor its mortal and cardiovascular consequences have been well described. Moreover, the prognostic value of electrocardiographic LVH has not been assessed in renal transplant patients.In a recently published study of CHF in renal transplant recipients (RTR), we documented that development of CHF incurred a strong adverse risk of death (19). As in dialysis patients, hypertension...

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“…1 8 Left ventricular systolic dysfunction (with or without associated dilation) is found in 15% to 18% of uremic patients 19 , and is a powerful indicator of unfavorable prognosis for patients on HD20 and after renal transplantation. 21 The adverse effect of systolic dysfunction does not dependent on left ventricular mass, but both alterations interact in predicting cardiovascular outcomes, and reach maximum risk in patients with an association of both. 22 Diastolic dysfunction is present in most individuals on renal replacement therapy.…”

Section: Morphofunctional Alterationsmentioning

confidence: 99%

Avaliação e manejo da doença cardiovascular em pacientes com doença renal crônica

Bucharles¹,

Varela²,

Barberato³

et al. 2010

J. Bras. Nefrol.

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Cardiovascular disease is the leading cause of death in the set of chronic kidney disease (CKD) patients, whether on renal replacement therapy or conservative treatment. A better understanding of cardiovascular risk factors, diagnostic approach and management are central keys to develop strategies to reduce cardiovascular mortality among those patients. This review article discusses some aspects of pathophysiology, investigation methods and current treatment of cardiovascular disease in CKD patients.

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Pre-operative echocardiographic abnormalities and adverse outcome following renal transplantation

Cited by 77 publications

References 14 publications

Echocardiographic Assessment of Left Ventricular Systolic Dysfunction in Chronic Kidney Disease Patients of a Rural Tertiary Medical Care Centre in West Bengal

Echocardiographic Assessment of Left Ventricular Systolic Dysfunction in Chronic Kidney Disease Patients of a Rural Tertiary Medical Care Centre in West Bengal

Electrocardiographic Left Ventricular Hypertrophy in Renal Transplant Recipients

Avaliação e manejo da doença cardiovascular em pacientes com doença renal crônica

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