Cardiovascular Comorbidities Are the Main Predictors of Cardiac Reverse Remodeling following Kidney Transplantation.

Abstract

BACKGROUND:

End-stage renal disease is associated with cardiac remodeling, which is partly reversible after kidney transplantation (KT). We aimed to determine the association of cardiovascular comorbidities or kidney-related factors with cardiac reverse remodeling after KT.

METHODS:

We performed echocardiography in 56 patients (aged 48 ± 15 years, mean ± SD) before and 24 months after undergoing their first KT. Echocardiograms were reviewed using a standardized process with blinding for the patient characteristics and evaluation timing. Multivariable linear regression analysis was used to evaluate the association between comorbidities and changes in cardiac structure and systolic/diastolic function.

RESULTS:

Left ventricular mass index (LVMI) and diastolic parameters did not change significantly, while left ventricular ejection fraction (LVEF) increased from 63.9 to 69.6% (p = 0.046). Multivariable analysis revealed associations of histories of valvular heart disease with a smaller reduction in LVMI (β = -27.3, p = 0.04), of coronary artery disease or heart failure with a smaller increase in LVEF (β = 7.17, p = 0.02), and of diabetes mellitus with less improvement in E wave (β = -0.19, p = 0.05), e' (β = 4.15, p = 0.046), and E/e' (β = -5.00, p < 0.01).

CONCLUSION:

Cardiovascular comorbidities were -associated with less improvement in cardiac structure and function following KT. Our findings suggest that patients with CV comorbidities may experience limited "favorable" reverse cardiac remodeling following KT.

• Authors: Masatake Kobayashi, Olivier Huttin, Johan Schikowski, Erwan Bozec, Lamiral Zohra, Luc Frimat, Nicolas Girerd, Sophie Girerd
• Journal: Cardiology (Cardiology) 2020 Vol. 145 Issue 2 Pg. 71-76 ISSN: 1421-9751 [Electronic] Switzerland
• PMID: 31910420 (Publication Type: Journal Article)
• Copyright: © 2020 S. Karger AG, Basel.

Topics

• Adult
• Comorbidity
• Echocardiography
• Female
• France
• Heart (physiopathology)
• Heart Failure (epidemiology, physiopathology)
• Humans
• Kidney (physiopathology)
• Kidney Failure, Chronic (epidemiology, physiopathology, surgery)
• Kidney Transplantation
• Linear Models
• Male
• Middle Aged
• Retrospective Studies
• Stroke Volume
• Ventricular Dysfunction, Left (physiopathology)
• Ventricular Remodeling