Open AccessDiastolic left ventricular function after renal transplantation in patients with normal and hypertrophied myocardium
Author(s) -
Hüting Jürgen
Publication year - 1992
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960151110
Subject(s) - medicine , isovolumic relaxation time , cardiology , transplantation , left ventricular hypertrophy , diastole , muscle hypertrophy , doppler echocardiography , renal function , isovolumetric contraction , blood pressure , creatinine , dialysis
While diastolic left ventricular (LV) dysfunction is frequent and associated with cardiovascular complications in end‐stage renal disease treated with dialysis, controversial information exists on diastolic LV function after renal transplantation. Therefore, Doppler echocardiographic parameters of LV diastolic filling were analyzed in 17 transplanted patients with normal LV mass (< 150 g/m 2 ; mean: 128 ± 17 g/m 2 ) and 24 transplanted patients with LV hypertrophy (>150 g/m 2 ; mean: 197 ± 36 g/m 2 ) and compared with 28 normal controls without and 11 controls with LV hypertrophy. Mean age (normal vs. increased LV mass: 46 ± 13 vs. 48 ± 11 years; p = NS) and transplantation duration (60 ± 35 vs. 50 ± 37 months; p = NS) were comparable between renal patients, while systolic blood pressure (136 ± 12 vs. 149 ± 14 mmHg; p < 0.02) and serum creatinine (1.55 ± 0.45 vs. 1.98 ± 0.76 mg/dl; p < 0.05) were higher in patients with than without LV hypertrophy. In transplanted patients with LV hypertrophy, peak early/atrial filling velocity ratios were decreased (1.17 ± 0.34 vs. 0.94 ± 0.34; p < 0.05), mean atrial filling fractions were increased (37 ± 7% vs. 42 ± 7%; p < 0.05), and isovolumic relaxation periods were prolonged (86 ± 23 vs. 106 ± 26 ms; p < 0.02) compared with transplanted patients with normal LV mass. The frequency of pathologic peak early/atrial filling velocity ratios (12 vs. 42%; p < 0.05), atrial filling fractions (12 vs. 25%; p = NS) and isovolumic relaxation periods (6 vs. 29%; p = NS) was higher in transplanted patients with than without LV hypertrophy. Individual ratios of peak early/atrial filling velocity were inversely correlated with age in transplanted patients with normal LV mass (p < 0.002), and atrial filling fractions were correlated with LV mass index in transplanted patients with LV hypertrophy (p < 0.01). Diastolic LV function was comparable in both groups of transplanted patients with their corresponding non‐renal controls. It is concluded that, in transplanted patients, diastolic LV filling is comparable to nonrenal controls; it is age‐dependent in patients with normal LV mass and mass‐dependent in those with LV hypertrophy.