Reduced coronary flow reserve in young adults with renal transplant

Abstract

CFR and IMT abnormalities are common in young transplant recipients, in spite of the fact that our paediatric population has much less of the atherosclerotic 'legacy' common to adult patients.

The prognostic role of myocardial strain indices and dipyridamole stress test in renal transplantation patients

“…CFR is considered a useful marker of functional changes in coronary circulation both in overt clinical cardiovascular diseases and in subclinical stages of various conditions. [25][26][27][28][29][30][31][32] Impaired CFR at baseline in RT patients has been previously demonstrated and was shown to be independent of the presence of impaired renal function 14,33 ; in the current study, RT patients had a relatively preserved renal function. RT patients have been shown to be at increased cardiovascular risk compared to healthy populations.…”

“…This increase in risk may be attributed mainly to the chronic effects of common cardiovascular risk factors (such as diabetes, hypertension, and dyslipidemia), the direct effect of chronic kidney dysfunction per se but also potential side effects of the immunosuppressive therapy. [13][14][15] It is well known that approximately 40%-50% of RT patients will experience a cardiovascular event (mostly heart failure-related) commonly by 3 years after RT. 15 Currently, we showed that decreased CFR may predict the occurrence of clinical outcomes at 3-year follow-up; one should consider that the sum of clinical events in our study was quite inhomogeneous (atherosclerotic vascular disease, calcific valvular disease, and renal disease progression) and the prognostic role of CFR needs to be further evaluated in larger studies in this population.…”

“…10 Impaired kidney function is a common clinical problem in modern world and is related to increased cardiovascular and total morbidity and mortality. [13][14][15] There have been a considerable number of studies showing the potential value of classic and novel echocardiographic indices (mostly 2DSTE related) in the assessment of cardiovascular disease progression and prognosis in CKD patients although more studies are needed in RT patients. 12 Traditional cardiovascular risk factors are more prevalent in RT patients than in the general population while CAD is the leading cause of morbidity and mortality in this population.…”

“…12 Traditional cardiovascular risk factors are more prevalent in RT patients than in the general population while CAD is the leading cause of morbidity and mortality in this population. [13][14][15] There have been a considerable number of studies showing the potential value of classic and novel echocardiographic indices (mostly 2DSTE related) in the assessment of cardiovascular disease progression and prognosis in CKD patients although more studies are needed in RT patients. 9,[16][17][18][19][20][21] The aim of the current study was to evaluate the role of classic, 2DSTE indices, and DIPSE-induced changes in echocardiographic parameters at baseline for the prediction of clinical events and echocardiographically assessed deterioration of cardiac function in a population of RT patients over a 3-year follow-up.…”

Impaired coronary microcirculation is associated with left ventricular diastolic dysfunction in end‐stage chronic kidney disease patients

“…Impaired CFR has been recorded in various groups of patients at high cardiovascular risk including patients with hypertension, hypercholesterolemia, or diabetes Similarly, patients with CKD have been reported to have decreased CFR in early stages of the disease but also in end‐stage patients on dialysis and after renal transplantation . These data together suggest that impaired microcirculation is a ubiquitous finding in all stages of CKD and is not confined to advanced disease stages or related to extra‐renal dialysis per se.…”