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Left ventricular function in children and adults after renal transplantation in childhood

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Abstract

Background

Renal transplantation improves left ventricular (LV) function, but cardiovascular mortality remains elevated. The aim of this cross-sectional study was to determine whether subclinical abnormalities of LV longitudinal function also persist in patients who underwent renal transplant in childhood.

Methods

Conventional and speckle tracking echocardiography was performed in 68 renal transplant recipients (34 children and 34 adults, median 9.8 years (range 2.0–28.4 years) after first transplantation and 68 age- and sex-matched healthy controls.

Results

Mean age at first transplantation was 8.8 ± 4.8 years. Forty-three percent had a pre-emptive transplant. Of the remaining, 70% received haemodialysis and 30% peritoneal dialysis on average for 6.9 months. Thirty-one percent of paediatric and 35% of adult patients had hypertension. LV mass index was increased in adult patients (92 ± 24 vs 75 ± 11 g/m2, P< 0.01). LV diastolic function and exercise capacity were impaired in both paediatric and adult patients. LV longitudinal peak systolic strain and strain rate were comparable in patients and controls. In multivariate analysis, systolic blood pressure and LV diastolic relaxation were the main covariates of LV peak systolic strain and strain rate (all P < 0.01).

Conclusions

Patients who underwent renal transplantation in childhood have abnormal LV diastolic function and impaired exercise capacity, despite preserved LV longitudinal systolic deformation.

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Acknowledgements

The authors gratefully acknowledge patients and parents for their participation, and Reinhard Seifert for statistical support. The study was supported by grants from the Foundation of Renée and Bredo Grimsgaard and The Red Cross Organization, Oslo, Norway.

Author information

Authors and Affiliations

  1. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Asle Hirth & Gottfried Greve

  2. Department of Paediatrics, Haukeland University Hospital, Bergen, Norway

    Asle Hirth

  3. Department of Cardiology, University Hospital Birmingham, Birmingham, United Kingdom

    Nicola C. Edwards

  4. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway

    Gottfried Greve & Eva Gerdts

  5. Department of Paediatric Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Trine Tangeraas, Kjetil Lenes & Gunnar Norgård

  6. Institute of Medicine, University of Bergen, Bergen, Norway

    Eva Gerdts

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  1. Asle Hirth
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  2. Nicola C. Edwards
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  3. Gottfried Greve
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Correspondence to Asle Hirth.

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Hirth, A., Edwards, N.C., Greve, G. et al. Left ventricular function in children and adults after renal transplantation in childhood. Pediatr Nephrol 27, 1565–1574 (2012). https://doi.org/10.1007/s00467-012-2167-z

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  • DOI: https://doi.org/10.1007/s00467-012-2167-z

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