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논문분류 춘계학술대회 초록집
제목 Effect of Kidney Transplantation on Left Ventricular Remodeling and Risk Factors for Post Transplant Left Ventricular Hypertrophy
저자 Jung Nam An1, Jin Ho Hwang2, Hee Jung Jeon2, Young Hoon Kim4, Yun Kyu Oh1,Duck-Jong Han4, Su-Kil Park4, Yon Su Kim3, Chun Soo Lim1, Jung Pyo Lee1
출판정보 2014; 2014(1):
키워드 신장이식, 좌심실비대
초록 Introduction: Cardiovascular disease is a leading cause of mortality in patients with end-stage renal disease, even undergoing transplantation. Left ventricular hypertrophy (LVH) is the most common feature and an independent risk factor for cardiac complications in kidney transplant recipients. The aim of this study was to identify cardiac alteration after kidney transplantation and analyze predictors of the post-transplant LVH. Methods: Among 2957 kidney transplant recipients in a multicenter cohort from 1997 to 2012, a total of 206 patients who conducted echocardiography before and one year after transplantation were enrolled in this study. Echocardiographic findings and clinical parameters were evaluated. Results: Kidney transplantation significantly reduced mean left ventricular mass index (LVMI) from 128.8±47.2 g/m2 to 106.4±33.0 g/m2 (p<0.001) (Fig. 1). The ejection fraction was improved (59.4±8.0% vs. 62.1±6.7%, p<0.001). The prevalence of LVH by echocardiography significantly decreased (62.6% vs. 46.1%, p=0.001). The prevalence of diastolic dysfunction, mitral and tricuspid regurgitation, and pulmonary hypertension also decreased. Pre-transplant lower hemoglobin level (OR 0.74, 95% CI 0.56-0.96, p=0.026) and pre-transplant higher LVMI (OR 1.02, 95% CI 1.01-1.02, p<0.001) were independently associated with persistent LVH after kidney transplantation. On the other hand, ejection fraction, diastolic dysfunction, underlying renal disease, albumin or cholesterol level, blood pressure, rejection, and allograft function were not correlated with post- transplant LVH. Conclusions: Cardiac morphology and function were significantly improved by kidney transplantation. Treatment of anemia might be crucial in regression and prevention of persistent LVH in kidney transplant recipients.
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