Ghahrodi Mohsen Sadeghi, Einollahi Behzad, Baharvand Amir, Javanbakht Mohammad
Department of Cardiology, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Mater Sociomed. 2019 Dec;31(4):241-245. doi: 10.5455/msm.2019.31.241-245.
Several studies have looked at cardiac complications in patients with end-stage renal disease (ESRD) after renal transplantation, but more attention has been paid to the long-term cardiovascular complications.
The present study was designed to investigate the short-term cardiovascular complications of intrahospital hospitalization in post-renal transplant patients and related factors.
In this retrospective cohort study, the medical records of all renal transplant patients in Baqiyatallah Hospital between 2015 and 2018 during the post-transplantation phase were investigated. Demographic data, transplantation type, cardiac risk factors, pre-operation cardiac consultation and para-clinical tests results were extracted from the patients' records. The frequency and factors influencing the need for re-visitation as well as its final diagnosis were analyzed.
A total of 982 patients with a mean age of 13.73 ± 45.33 years were studied (62.6% males). In 39.8% of patients, cardiology re-visitation was required; of these 391 visits, only 162 patients (41.4%) had heart problems. In multivariate analysis, patients' need for cardiac reconsideration was predicted by 7 variables; age, diabetes, history of CABG, ECG, echocardiography, angiography, and myocardial perfusion scan (R = 0.652, P <0.001). Furthermore, the five variables of first cardiology consultant, the first consultation physician, left ventricular hypertrophy, having history of angiography and myocardial perfusion scan, can predict the final diagnosis of cardiac problems in re-counseling (R = 0.188, P = 0.043).
Given the high prevalence of need for a patient's recurrent cardiac visit, it seems that risk assessment prior to kidney transplantation needs to be more accurate. It is recommended that elderly patients with abnormal findings in electrocardiography and echocardiography, having diabetes, having a history of negative coronary angiography or myocardial perfusion scan be more closely monitored for heart disease.
多项研究关注了肾移植术后终末期肾病（ESRD）患者的心脏并发症，但更多的注意力集中在长期心血管并发症上。
本研究旨在调查肾移植术后患者院内住院期间的短期心血管并发症及其相关因素。
在这项回顾性队列研究中，调查了2015年至2018年期间巴基耶塔拉医院所有肾移植患者移植后阶段的病历。从患者记录中提取人口统计学数据、移植类型、心脏危险因素、术前心脏会诊和辅助检查结果。分析了影响再次就诊需求的频率和因素及其最终诊断。
共研究了982例患者，平均年龄为13.73±45.33岁（男性占62.6%）。39.8%的患者需要心脏科复诊；在这391次复诊中，只有162例患者（41.4%）有心脏问题。多因素分析显示，7个变量可预测患者对心脏复查的需求；年龄、糖尿病、冠状动脉搭桥术史、心电图、超声心动图、血管造影和心肌灌注扫描（R = 0.652，P <0.001）。此外，首次心脏科会诊医生、首诊医生、左心室肥厚、有血管造影和心肌灌注扫描史这5个变量可预测再次会诊时心脏问题的最终诊断（R = 0.188，P = 0.043）。
鉴于患者反复心脏就诊的高发生率，肾移植前的风险评估似乎需要更加准确。建议对心电图和超声心动图检查结果异常、患有糖尿病、有冠状动脉造影阴性或心肌灌注扫描史的老年患者进行更密切的心脏病监测。
