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Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression

BACKGROUND: Valve regurgitation can decrease with resolution of hemodynamic loads on the left ventricle (LV) after kidney transplantation (KT). We aimed to investigate the natural course of left-side valve regurgitation after KT and factors associated with progression. METHODS: Among patients who un...

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Autores principales: Kim, Minjeong, Kim, Darae, Lee, Juhan, Kim, Dae-Young, Seo, Jiwon, Cho, Iksung, Huh, Kyu Ha, Hong, Geu-Ru, Ha, Jong-Won, Shim, Chi Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8829463/
https://www.ncbi.nlm.nih.gov/pubmed/35155633
http://dx.doi.org/10.3389/fcvm.2022.809707
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author Kim, Minjeong
Kim, Darae
Lee, Juhan
Kim, Dae-Young
Seo, Jiwon
Cho, Iksung
Huh, Kyu Ha
Hong, Geu-Ru
Ha, Jong-Won
Shim, Chi Young
author_facet Kim, Minjeong
Kim, Darae
Lee, Juhan
Kim, Dae-Young
Seo, Jiwon
Cho, Iksung
Huh, Kyu Ha
Hong, Geu-Ru
Ha, Jong-Won
Shim, Chi Young
author_sort Kim, Minjeong
collection PubMed
description BACKGROUND: Valve regurgitation can decrease with resolution of hemodynamic loads on the left ventricle (LV) after kidney transplantation (KT). We aimed to investigate the natural course of left-side valve regurgitation after KT and factors associated with progression. METHODS: Among patients who underwent KT in two tertiary centers, 430 (224 men, mean age 50 ± 13 years) were examined by echocardiography within 3 months before KT and between 6 and 36 months after KT. Mitral regurgitation (MR) and aortic regurgitation (AR) were graded according to the current guidelines. Regression was defined as a decrease in regurgitation by one or more steps, and progression was an increase in one or more steps after KT. Clinical and echocardiographic factors associated with progression of MR and AR were analyzed. RESULTS: Mild or greater MR was observed in 216 (50%) patients before KT, and mild or greater AR was observed in 99 (23%). During the follow-up period of 23.4 ± 9.9 months, most patients experienced regression or no change in regurgitation after KT, but 34 patients (7.9%) showed MR progression and 37 (8.6%) revealed AR progression. Patients who showed MR progression were more likely to receive a second KT, have mitral annular calcifications, and show a smaller decrease in LV end-systolic dimension. Patients who showed AR progression were more likely to have persistent hypertension after KT, aortic valve calcifications, and a smaller reduction of LV end-systolic dimension. CONCLUSIONS: Risk factors for progression of MR after KT include a second KT, MAC and a smaller decrease in LV end-systolic dimension after KT. Risk factors for progression of AR include valve calcification, persistent hypertension and a smaller decrease in LV end-systolic dimension after KT. Further echocardiographic surveillance and risk factor management after KT are warranted in these patients.
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spelling pubmed-88294632022-02-11 Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression Kim, Minjeong Kim, Darae Lee, Juhan Kim, Dae-Young Seo, Jiwon Cho, Iksung Huh, Kyu Ha Hong, Geu-Ru Ha, Jong-Won Shim, Chi Young Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Valve regurgitation can decrease with resolution of hemodynamic loads on the left ventricle (LV) after kidney transplantation (KT). We aimed to investigate the natural course of left-side valve regurgitation after KT and factors associated with progression. METHODS: Among patients who underwent KT in two tertiary centers, 430 (224 men, mean age 50 ± 13 years) were examined by echocardiography within 3 months before KT and between 6 and 36 months after KT. Mitral regurgitation (MR) and aortic regurgitation (AR) were graded according to the current guidelines. Regression was defined as a decrease in regurgitation by one or more steps, and progression was an increase in one or more steps after KT. Clinical and echocardiographic factors associated with progression of MR and AR were analyzed. RESULTS: Mild or greater MR was observed in 216 (50%) patients before KT, and mild or greater AR was observed in 99 (23%). During the follow-up period of 23.4 ± 9.9 months, most patients experienced regression or no change in regurgitation after KT, but 34 patients (7.9%) showed MR progression and 37 (8.6%) revealed AR progression. Patients who showed MR progression were more likely to receive a second KT, have mitral annular calcifications, and show a smaller decrease in LV end-systolic dimension. Patients who showed AR progression were more likely to have persistent hypertension after KT, aortic valve calcifications, and a smaller reduction of LV end-systolic dimension. CONCLUSIONS: Risk factors for progression of MR after KT include a second KT, MAC and a smaller decrease in LV end-systolic dimension after KT. Risk factors for progression of AR include valve calcification, persistent hypertension and a smaller decrease in LV end-systolic dimension after KT. Further echocardiographic surveillance and risk factor management after KT are warranted in these patients. Frontiers Media S.A. 2022-01-27 /pmc/articles/PMC8829463/ /pubmed/35155633 http://dx.doi.org/10.3389/fcvm.2022.809707 Text en Copyright © 2022 Kim, Kim, Lee, Kim, Seo, Cho, Huh, Hong, Ha and Shim. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Kim, Minjeong
Kim, Darae
Lee, Juhan
Kim, Dae-Young
Seo, Jiwon
Cho, Iksung
Huh, Kyu Ha
Hong, Geu-Ru
Ha, Jong-Won
Shim, Chi Young
Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title_full Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title_fullStr Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title_full_unstemmed Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title_short Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression
title_sort mitral and aortic regurgitation in patients undergoing kidney transplantation: the natural course and factors associated with progression
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8829463/
https://www.ncbi.nlm.nih.gov/pubmed/35155633
http://dx.doi.org/10.3389/fcvm.2022.809707
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