Montanaro D, Gropuzzo M, Tulissi P, Vallone C, Boscutti G, Mioni R, Risaliti A, Baccarani U, Adani G L, Sainz M, Lorenzin D, Bresadola F, Mioni G
Division of Nephrology, S.Maria della Misericordia Hospital, Udine, Italy.
Transplant Proc. 2005 Jul-Aug;37(6):2485-7. doi: 10.1016/j.transproceed.2005.06.022.
Left ventricular hypertrophy is an independent cardiovascular risk factor in the general population and in patients with chronic renal failure. Relatively little is known about the effects of renal transplantation on left ventricular hypertrophy. The aim of this study was to determine the changes in left ventricular mass after successful renal transplantation and to evaluate the importance of some clinical, laboratory, and echocardiographic variables on the trend to left ventricular hypertrophy. Twenty-three patients with end-stage renal disease were studied by ambulatory blood pressure monitoring and echocardiography before and 2 years following renal transplantation. After 24 months of follow-up, all transplant recipients had adequate renal function (serum creatinine <2 mg/dL). At the end of the study, we observed a significant decrease in left ventricular mass and left ventricular mass index compared to the pretransplantation period. In renal transplant recipients, the prevalence of left ventricular hypertrophy significantly decreased (78% versus 44%, P < .03) after 2 years of follow-up. Systolic 24-hour blood pressure was the only predictor of left ventricular mass and of left ventricular mass index at 2 years after transplantation. In conclusion, successful renal transplantation produces a regression of left ventricular hypertrophy. This beneficial effect depends on a decrease in systolic pressure levels.
左心室肥厚在普通人群和慢性肾衰竭患者中是一个独立的心血管危险因素。关于肾移植对左心室肥厚的影响,人们了解得相对较少。本研究的目的是确定成功肾移植后左心室质量的变化,并评估一些临床、实验室和超声心动图变量对左心室肥厚趋势的重要性。对23例终末期肾病患者在肾移植前及移植后2年进行动态血压监测和超声心动图检查。经过24个月的随访,所有移植受者的肾功能均良好(血清肌酐<2mg/dL)。在研究结束时,我们观察到与移植前相比,左心室质量和左心室质量指数显著降低。在肾移植受者中,随访2年后左心室肥厚的患病率显著降低(78%对44%,P<.03)。移植后2年,24小时收缩压是左心室质量和左心室质量指数的唯一预测因素。总之,成功的肾移植可使左心室肥厚消退。这种有益效果取决于收缩压水平的降低。