Prevalence of Cardiovascular Disease in Kidney Transplant Candidates: Outpatient Cardiac Evaluation

Barrionuevo, J.D. Arjona; Vargas-Machuca, M.F. Gonzáles; Pulido, Federico; Sacaluga, Luis Gil; Govantes, M.A. Gentil; Martı́nez, Ángel

doi:10.1016/j.transproceed.2010.05.077

Cited by 11 publications

(6 citation statements)

References 2 publications

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“…3,4 LV systolic and diastolic dysfunction are also frequent findings in patients with ESKD, with many patients remaining asymptomatic. 5 It has been shown that diastolic dysfunction is associated with adverse cardiovascular events in ESKD patients 6 even though these patients are optimally treated with regular dialysis and close monitoring of their blood pressure. The fact that patients with ESKD develop diastolic dysfunction due to cardiac remodeling and hemodynamic changes, but in many cases have an intact systolic function, suggests that diastolic function is an early marker of cardiac pathology in ESKD.…”

Section: Introductionmentioning

confidence: 99%

“…In individuals with ESKD, left ventricular (LV) hypertrophy is one of the most common echocardiographic findings and can be found in patients with preserved systolic function 3,4 . LV systolic and diastolic dysfunction are also frequent findings in patients with ESKD, with many patients remaining asymptomatic 5 . It has been shown that diastolic dysfunction is associated with adverse cardiovascular events in ESKD patients 6 even though these patients are optimally treated with regular dialysis and close monitoring of their blood pressure.…”

Section: Introductionmentioning

confidence: 99%

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The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

et al. 2021

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Background: Diastolic dysfunction is an early marker of cardiac pathology in end-stage kidney disease (ESKD) patients. The ratio of transmitral filling velocity (E) to early diastolic strain rate (E/e'sr) is a novel non-invasive marker of early left ventricular (LV) filling pressure obtained using two-dimensional speckle tracking echocardiography (2DSTE).Methods: In a prospective cohort of kidney transplant (KTX) recipients with echocardiograms performed pre-transplant we obtained repeat echocardiograms at 6 months following transplant. All echocardiograms were analyzed using 2DSTE where E/e'sr and global longitudinal strain were obtained. Paired tests were used to assess changes to cardiac structure and function following KTX.Results: A total of 33 patients were included in the study (mean age was 46.6 ± 13.7 years and 42% were males). The primary causes of ESKD in the cohort were glomerular disease (33%), hypertension (30%), and polycystic kidney disease (12%). The median (IQR) time spent on dialysis was 5.4 years [2.9, 7.7 years]. A reverse remodeling of the LV was observed following KTX as LV mass decreased (189.2 ± 57.5 g vs 171.1 ± 56.8 g, P = 0.014). LV filling pressure decreased as assessed by E/e'sr (103.7 ± 51.1 cm vs 72.6 ± 35.5 cm, P = 0.009). E to early diastolic mitral annular tissue velocity (E/e') did not change following KTX (9.9 ± 4.5 vs 10.3 ± 4.1, P = 0.54). Additionally, both LV internal diastolic and systolic diameter decreased significantly. Conclusion:Reverse cardiac remodeling following KTX was observed as improvements in LV mass and LV dimensions. LV filling pressure improved as assessed by E/e'sr decreased following KTX, whereas E/e' did not change.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

et al. 2021

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“…Left ventricular (LV) systolic and diastolic dysfunction had a prevalence of 38.4% in ESRD patients most of whom (82%) were asymptomatic. 2 However, symptomatic heart failure in ESRD patients (ejection fraction [EF] less than 40%) is shown to be associated with lower survival. 3 The most prevalent echocardiographic finding in ESRD patients is LV hypertrophy (56.9%) and most of these patients had a normal systolic function.…”

Section: Introductionmentioning

confidence: 99%

The effect of kidney transplantation on speckled tracking echocardiography findings in patients on hemodialysis

Hamidi¹,

Kojuri²,

Attar³

et al. 2018

J Cardiovasc Thorac Res

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Introduction: Cardiac dysfunction is a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD). Previous studies have shown that kidney transplantation can reverse some of the gross changes in the myocardial structure such as left ventricular ejection fraction (LVEF) and volumes. Whether kidney transplantation can reverse the subtle and early myocardial changes in ESRD patients who do not suffer from gross alternations in myocardial function is not yet studied. The aim of this study was to answer this question. Methods: We followed 25 patients with ESRD at baseline that all of them had a kidney transplant and were reassessed 1 month after the transplantation. Conventional and speckle tracking echocardiography (STE)was done at baseline and 1 month after kidney transplantation in patients. Results: LV hypertrophy was the most prevalent finding at baseline (58%), followed by diastolic dysfunction (53%). Kidney transplantation significantly improved the ejection fraction (EF) (treatment effect = 4.23 ± 2.06%; P = 0.046) and apical 4-chamber strain (treatment effect = -0.89 ± 0.37%; P = 0.021) in the patients. It also reduced the LV mass index (treatment effect = -73.82 ± 11.6; P < 0.001) and relative wall thickness (treatment effect = -0.056±0.023; P = 0.021). Other variables including global longitudinal strain and diastolic dysfunction were not improved significantly. Conclusion: STE may show early improvements in myocardial function 1 month after renal transplantation.

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“…Cardiovascular disease is a leading cause of morbidity and mortality in patients with end-stage renal disease [1]. The modification of coronary risk factors is an integral part of the management [2,3] of such patients.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography Predicts Major Adverse Cardiovascular Events after Renal Transplantation

Gu¹,

Akhtar²,

Shah³

et al. 2014

Nephron Clin Pract

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Introduction: Cardiovascular disease is a leading cause of morbidity and mortality after renal transplantation. We analysed whether pre-transplant transthoracic echocardiograms (TTE) predicted major adverse cardiovascular events (MACE) after transplant. Methods: We retrospectively analysed clinical and TTE data from patients having renal transplantation at a single centre between 1 January 2000 and 31 December 2010. The TTE were classified as: group A - normal; group B - mild abnormalities expected in renal failure; group C - moderate to severe abnormalities likely to change management. They were also scored based on four independent risk factors [age ≥50, left ventricular (LV) end systolic diameter ≥3.5 cm, LV wall thickness ≥1.4 cm and mitral annulus calcification]. Post-transplantation clinical notes were examined for MACE (death, stroke, myocardial infarction, and surgical or percutaneous revascularisation). Results: There were 343 patients, mean age 47 (range 21-83) years, 210 of whom were male. MACE occurred in 29 (8.5%) at a mean of 3.6 (SD 3.3) years after transplantation. They were older (p ≤ 0.001), had larger LV mass (p = 0.02), LV wall thickness (p = 0.008) and left atrial size (p = 0.001) than those without MACE. The MACE rate for groups A, B and C were 1.8, 13.6 and 16.4% (p ≤ 0.001), respectively. Using the score, the risk of MACE was 4.7, 10.7, 9.2 and 40% for scores 0, 1, 2 and 3 (p = 0.023), respectively. Conclusion: Preoperative transthoracic echocardiography identifies patients at risk of death or non-fatal cardiovascular events even late after renal transplantation. This suggests that echocardiography might be useful to identify patients requiring more aggressive long-term treatment of modifiable vascular risk factors.

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Prevalence of Cardiovascular Disease in Kidney Transplant Candidates: Outpatient Cardiac Evaluation

Cited by 11 publications

References 2 publications

The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease

The effect of kidney transplantation on speckled tracking echocardiography findings in patients on hemodialysis

Echocardiography Predicts Major Adverse Cardiovascular Events after Renal Transplantation

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