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Renal Transplantation Is Not Associated with Regression of Left Ventricular Hypertrophy: A Magnetic Resonance Study

Rajan K. Patel^*,, Patrick B. Mark^*,, Nicola Johnston, Ellon McGregor, Henry J. Dargie, and Alan G. Jardine^*,

^* BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom; and Departments of Renal Medicine and Cardiology, Western Infirmary, Glasgow, United Kingdom

Correspondence: Prof. Alan G Jardine, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA, United Kingdom. Phone: +44 141 330 2705; Fax: +44 141 330 6972; E-mail: a.g.jardine{at}clinmed.gla.ac.uk

Background and objectives: Patients with end-stage renal failure (ESRD) have an increased risk of premature cardiovascular (CV) disease. Left ventricular hypertrophy is an independent risk factor for CV events and death in ESRD. Renal transplantation has been associated with reduction in CV risk and echocardiographic regression of left ventricular hypertrophy. However, echocardiography overestimates LV mass in ESRD patients. Cardiac magnetic resonance (CMR) provides more detailed, volume-independent, measures of cardiac structure. Changes in LV mass measured by CMR after renal transplantation were studied.

Design, setting, participants, & measurements: Fifty patients underwent CMR on two occasions. Twenty-five were transplanted before the second scan. CMR was performed to measure LV mass index (LVMI), ejection fraction, end-diastolic and end-systolic volumes. Changes were expressed as percentage change over time. Patients with CV events between scans (e.g., acute coronary syndrome, myocardial infarction) were excluded. All transplant patients had serum creatinine <150 µmol/L.

Results: There was no significant change in LVMI between patients who underwent renal transplantation and those who remained on dialysis (transplanted mean, 2.75%/yr, ± 9.1 versus dialysis, –3.6%/yr ± 16.7). In addition, there were no significant changes in end-diastolic volume (transplant, 0.1%/yr ± 19.5 versus not transplanted, –3.4%/yr ± 31.5), end-systolic volume (transplanted mean, 15.2%/yr ± 65.2 versus not transplanted, 3.0%/yr ± 55.5), or ejection fraction (transplant, 2.1%/yr ± 11.9 versus not transplanted, –0.4%/yr ± 5.3).

Conclusions: Renal transplantation is not associated with significant regression of LVMI on CMR compared with patients who remain on the transplant waiting list.

This article has been cited by other articles:

				I. Mimura, H. Kawarazaki, T. Momose, Y. Shibagaki, and T. Fujita Improvement of cardiac function after kidney transplantation with dilated cardiomyopathy and long dialysis vintage NDT Plus, December 1, 2009; 2(6): 479 - 481. [Abstract] [Full Text] [PDF]