Premium
A prospective, longitudinal study of the improvement of vascular function and cardiac autonomic control following renal transplantation
Author(s) -
Ferrante Kimberly P,
Stauss Harald M,
Kalil Roberto S
Publication year - 2012
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.26.1_supplement.1101.8
Subject(s) - medicine , heart rate variability , cardiology , endothelial dysfunction , transplantation , cardiac function curve , renal function , autonomic nervous system , heart transplantation , heart rate , heart failure , blood pressure
Uremic state is strongly associated with autonomic nervous system dysfunction and impaired endothelial vascular function. Furthermore, decreased heart rate variability (HRV) in patients with ESRD is associated with higher rates of cardiovascular events. Therefore, we studied endothelial vascular function and cardiac autonomic control in patients with ESRD before and 3 months, 12 months, and 36 months following renal transplantation (RT). Vascular function was assessed by flow mediated dilatation (FMD) and cardiac autonomic control was assessed by time‐ and frequency‐domain HRV analysis. FMD increased by 50% at one year after RT. One year following RT, time‐ and frequency‐domain HRV parameters tended to increase (e.g., RMSSD 20.7±1.9 ms before RT vs. 25.3±5.4 ms one year after RT), indicating improved autonomic cardiac control. Compared to one year following RT, HRV parameters tended to be slightly lower at 3 years following RT, but were still greater than before RT. Importantly, HRV (SDNN) correlated significantly (R=0.4, P<0.05) with FMD. We conclude that renal transplantation in ESRD patients chronically improves endothelial vascular function and cardiac autonomic control. We speculate that improved endothelial vascular function contributes to reduced cardiovascular events following RT in ESRD patients. Supported by: National Institutes of Health (NHLBI K23 HL080410)