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Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study

BACKGROUND: Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factor...

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Autores principales: Patel, Rajan K, Pennington, Christopher, Stevens, Kathryn K, Taylor, Alison, Gillis, Keith, Rutherford, Elaine, Johnston, Nicola, Jardine, Alan G, Mark, Patrick B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261520/
https://www.ncbi.nlm.nih.gov/pubmed/25505546
http://dx.doi.org/10.1186/s13737-014-0020-6
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author Patel, Rajan K
Pennington, Christopher
Stevens, Kathryn K
Taylor, Alison
Gillis, Keith
Rutherford, Elaine
Johnston, Nicola
Jardine, Alan G
Mark, Patrick B
author_facet Patel, Rajan K
Pennington, Christopher
Stevens, Kathryn K
Taylor, Alison
Gillis, Keith
Rutherford, Elaine
Johnston, Nicola
Jardine, Alan G
Mark, Patrick B
author_sort Patel, Rajan K
collection PubMed
description BACKGROUND: Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factors for reduced survival in patients with end stage renal disease (ESRD). In the present analysis, we studied the impact of pre-transplant LA and LV abnormalities on survival after successful renal transplantation (RT). METHODS: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected. RESULTS: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant. CONCLUSIONS: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation.
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spelling pubmed-42615202014-12-10 Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study Patel, Rajan K Pennington, Christopher Stevens, Kathryn K Taylor, Alison Gillis, Keith Rutherford, Elaine Johnston, Nicola Jardine, Alan G Mark, Patrick B Transplant Res Research BACKGROUND: Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factors for reduced survival in patients with end stage renal disease (ESRD). In the present analysis, we studied the impact of pre-transplant LA and LV abnormalities on survival after successful renal transplantation (RT). METHODS: One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected. RESULTS: Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant. CONCLUSIONS: Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation. BioMed Central 2014-12-03 /pmc/articles/PMC4261520/ /pubmed/25505546 http://dx.doi.org/10.1186/s13737-014-0020-6 Text en © Patel et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Patel, Rajan K
Pennington, Christopher
Stevens, Kathryn K
Taylor, Alison
Gillis, Keith
Rutherford, Elaine
Johnston, Nicola
Jardine, Alan G
Mark, Patrick B
Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title_full Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title_fullStr Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title_full_unstemmed Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title_short Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
title_sort effect of left atrial and ventricular abnormalities on renal transplant recipient outcome—a single-center study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261520/
https://www.ncbi.nlm.nih.gov/pubmed/25505546
http://dx.doi.org/10.1186/s13737-014-0020-6
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