Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient

Introduction: ardiovascular disease (CVD) is the major cause of death among renal transplant recipients (RTR). It is not known whether echocardiographic abnormalities are useful to identify RTR at high risk of CVD. Methods: Retrospective review of RTR with functioning and stable graft and an echocardiography performed in the last year. Risk of major adverse cardiac events (MACE) and death using a risk calculator specific for RTR. Results: Among 107 patients (57.9% males, 50.4±13.9 years), 7-year risk of MACE was >10% in 30.9% of patients and 7-year risk of death >10% in 56.1%. Left ventricular hypertrophy (LVH) was found in 55.1%, diastolic dysfunction in 39.3%, dilated left atrium (LA) in 53.3%, high pulmonary artery systolic pressure (PASP) in 29.0%, valvular calcifications in 22.4% and moderate to severe mitral regurgitation (MR) in 3.7%. Mean Ejection fraction was 68.36±6.87%. Univariate analysis showed an increased risk of MACE and death in patients with LVH, diastolic dysfunction, dilated LA, high PASP, valvular calcifications and MR. Multivariate analysis identified an independent association between the risk of MACE >10% and valvular calcifications and high PASP. Risk of death>10% in multivariate analysis had an independent association with diastolic dysfunction and elevated PASP. Conclusion: Echocardiographic abnormalities identify RTR at increased risk of MACE and death. Valvular calcifications and high PASP are predictors of MACE whereas diastolic dysfunction and high PASP predict death.

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Main Authors: Gonçalves,Miguel, Neto,Micaela, Pestana,Nicole, Resende,Luís, Vieira,Pedro, Gomes,Susana, Durães,José, Rosa,Nuno, Teixeira,José Alves, Silva,Gil
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Nefrologia 2017
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000300002
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spelling oai:scielo:S0872-016920170003000022017-11-09Echocardiography and cardiovascular risk: The relationship in the renal transplant recipientGonçalves,MiguelNeto,MicaelaPestana,NicoleResende,LuísVieira,PedroGomes,SusanaDurães,JoséRosa,NunoTeixeira,José AlvesSilva,Gil Cardiovascular risk calculator Diastolic dysfunction Echocardiography Pulmonary hypertension Renal transplant recipient Valvular calcifications Introduction: ardiovascular disease (CVD) is the major cause of death among renal transplant recipients (RTR). It is not known whether echocardiographic abnormalities are useful to identify RTR at high risk of CVD. Methods: Retrospective review of RTR with functioning and stable graft and an echocardiography performed in the last year. Risk of major adverse cardiac events (MACE) and death using a risk calculator specific for RTR. Results: Among 107 patients (57.9% males, 50.4±13.9 years), 7-year risk of MACE was >10% in 30.9% of patients and 7-year risk of death >10% in 56.1%. Left ventricular hypertrophy (LVH) was found in 55.1%, diastolic dysfunction in 39.3%, dilated left atrium (LA) in 53.3%, high pulmonary artery systolic pressure (PASP) in 29.0%, valvular calcifications in 22.4% and moderate to severe mitral regurgitation (MR) in 3.7%. Mean Ejection fraction was 68.36±6.87%. Univariate analysis showed an increased risk of MACE and death in patients with LVH, diastolic dysfunction, dilated LA, high PASP, valvular calcifications and MR. Multivariate analysis identified an independent association between the risk of MACE >10% and valvular calcifications and high PASP. Risk of death>10% in multivariate analysis had an independent association with diastolic dysfunction and elevated PASP. Conclusion: Echocardiographic abnormalities identify RTR at increased risk of MACE and death. Valvular calcifications and high PASP are predictors of MACE whereas diastolic dysfunction and high PASP predict death.info:eu-repo/semantics/openAccessSociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.31 n.3 20172017-09-01info:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000300002en
institution SCIELO
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country Portugal
countrycode PT
component Revista
access En linea
databasecode rev-scielo-pt
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Gonçalves,Miguel
Neto,Micaela
Pestana,Nicole
Resende,Luís
Vieira,Pedro
Gomes,Susana
Durães,José
Rosa,Nuno
Teixeira,José Alves
Silva,Gil
spellingShingle Gonçalves,Miguel
Neto,Micaela
Pestana,Nicole
Resende,Luís
Vieira,Pedro
Gomes,Susana
Durães,José
Rosa,Nuno
Teixeira,José Alves
Silva,Gil
Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
author_facet Gonçalves,Miguel
Neto,Micaela
Pestana,Nicole
Resende,Luís
Vieira,Pedro
Gomes,Susana
Durães,José
Rosa,Nuno
Teixeira,José Alves
Silva,Gil
author_sort Gonçalves,Miguel
title Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
title_short Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
title_full Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
title_fullStr Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
title_full_unstemmed Echocardiography and cardiovascular risk: The relationship in the renal transplant recipient
title_sort echocardiography and cardiovascular risk: the relationship in the renal transplant recipient
description Introduction: ardiovascular disease (CVD) is the major cause of death among renal transplant recipients (RTR). It is not known whether echocardiographic abnormalities are useful to identify RTR at high risk of CVD. Methods: Retrospective review of RTR with functioning and stable graft and an echocardiography performed in the last year. Risk of major adverse cardiac events (MACE) and death using a risk calculator specific for RTR. Results: Among 107 patients (57.9% males, 50.4±13.9 years), 7-year risk of MACE was >10% in 30.9% of patients and 7-year risk of death >10% in 56.1%. Left ventricular hypertrophy (LVH) was found in 55.1%, diastolic dysfunction in 39.3%, dilated left atrium (LA) in 53.3%, high pulmonary artery systolic pressure (PASP) in 29.0%, valvular calcifications in 22.4% and moderate to severe mitral regurgitation (MR) in 3.7%. Mean Ejection fraction was 68.36±6.87%. Univariate analysis showed an increased risk of MACE and death in patients with LVH, diastolic dysfunction, dilated LA, high PASP, valvular calcifications and MR. Multivariate analysis identified an independent association between the risk of MACE >10% and valvular calcifications and high PASP. Risk of death>10% in multivariate analysis had an independent association with diastolic dysfunction and elevated PASP. Conclusion: Echocardiographic abnormalities identify RTR at increased risk of MACE and death. Valvular calcifications and high PASP are predictors of MACE whereas diastolic dysfunction and high PASP predict death.
publisher Sociedade Portuguesa de Nefrologia
publishDate 2017
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000300002
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