Improvement in Echocardiographic Indexes of Systolic Heart Failure Post-Kidney Transplantation: A Retrospective Analysis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Pub Date : 2024-01-01 Epub Date: 2024-03-26 DOI:10.1159/000538476

Keren Skalsky, Leor Perl, Benaya Rozen Zvi, Mohamad Atamna, Ran Kornowski, Eviatar Nesher, Ruth Rahamimov, Tuvia Ben Gal, Yaron Shapira, Arthur Shiyovich, Tali Steinmetz

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Abstract

Introduction: End-stage renal disease is a major risk factor for cardiovascular morbidity and mortality, which can be partially eliminated by kidney transplantation. Systolic heart failure might be considered contraindication for kidney transplant, although some patients demonstrate myocardial recovery post-transplant. We aimed to identify and characterize the phenomenon of reverse myocardial remodeling in kidney transplanted patients.

Methods: The study is a retrospective cohort of patients undergoing kidney transplants between 2016 and 2019 (n = 604) at Rabin Medical Center. Patients were assessed according to availability of two echocardiographic examinations: pre- and post-kidney transplant. The change in estimated ejection fraction (EF) and possible predictors of myocardial recovery were examined.

Results: Data of 293 patients was available for the final analysis. Eighty-one (28%) patients had a LVEF improvement equal to or above 5%, whereas 36 (12%) patients had a LVEF improvement of 10% or more post-transplantation. Twenty-five patients (8.5%) had moderate or severe systolic heart failure with LVEF reduced to 40% or less at baseline. 13 of them (52%) had a LVEF improvement of ≥5%, and 10 patients (40%) had an improvement of ≥10% in their EF. Cox regression analyses identified female gender as the only independent variable associated with LVEF improvement of at least 10%.

Conclusion: Renal transplantation might lead to improved LV systolic function in some patients.

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肾移植后收缩性心力衰竭超声心动图指标的改善--回顾性分析

简介终末期肾病（ESRD）是心血管疾病发病率和死亡率的主要风险因素，而肾移植可以部分消除这一风险。收缩性心力衰竭可能被视为肾移植的禁忌症，尽管有些患者在移植后心肌得到恢复。我们旨在确定肾移植患者心肌反向重塑现象的特征：本研究是一项回顾性队列研究，研究对象为 2016-2019 年间在拉宾医疗中心接受肾移植的患者（n=604）。根据肾移植前和肾移植后两次超声心动图检查的可用性对患者进行评估。研究了估计射血分数（EF）的变化和心肌恢复的可能预测因素：最终分析获得了 293 名患者的数据。81名患者（28%）的射血分数提高了5%或以上，36名患者（12%）的射血分数提高了10%或以上。25名患者（8.5%）患有中度或重度收缩性心力衰竭，基线时LVEF降至40%或以下。其中13名患者（52%）的LVEF改善幅度≥5%，10名患者（40%）的EF改善幅度≥10%。Cox 回归分析发现，女性是唯一与 LVEF 至少改善 10% 相关的自变量。结论肾移植可改善部分患者的左心室收缩功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.