Left ventricular mass and heart sympathetic activity after renal transplantation in children and young adults

Recent studies considered that an increase in sympathetic activity (SA) may be responsible for left ventricular hypertrophy (LVH). Before and after renal transplantation (RT), we evaluated changes on left ventricular mass (LVM) and SA in 40 end-stage renal disease patients between 8 and 35 years old...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2006-10, Vol.21 (10), p.1413-1418
Main Authors: Guízar-Mendoza, Juan Manuel, Amador-Licona, Norma, Lozada, Efrén Edgard, Rodriguez, Leticia, Gutiérrez-Navarro, María, Dubey-Ortega, Luis Antonio, Trejo-Bellido, José, Encarnación, José de Jesús, Ruiz-Jaramillo, María De la Cruz
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antihypertensive Agents - therapeutic use
Care and treatment
Child
Cohort Studies
Complications and side effects
Drug therapy
Echocardiography
Female
Heart - innervation
Heart - physiopathology
Heart enlargement
Heart Ventricles - pathology
Humans
Hypertension
Hypertension - complications
Hypertension - drug therapy
Hypertension - physiopathology
Hypertrophy, Left Ventricular - diagnosis
Hypertrophy, Left Ventricular - etiology
Hypertrophy, Left Ventricular - pathology
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Kidney Failure, Chronic - surgery
Kidney Transplantation
Kidneys
Living Donors
Logistic Models
Male
Postoperative Complications
Risk factors
Sympathetic Nervous System - drug effects
Sympathetic Nervous System - physiology
Transplantation
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Summary:Recent studies considered that an increase in sympathetic activity (SA) may be responsible for left ventricular hypertrophy (LVH). Before and after renal transplantation (RT), we evaluated changes on left ventricular mass (LVM) and SA in 40 end-stage renal disease patients between 8 and 35 years old. Hypertension (95.0% vs. 71.0%; p=0.005), use of combined antihypertensive drugs (57.5% vs. 30.0%; p=0.01), and LVH (77.5% vs. 52.5%; p=0.01) significantly decreased after RT whereas low-to-high frequency ratio (LF/HF), which represents SA, increased (3.1 vs. 5.3; p=0.0001). However, LVM regressors (with decrease on LVM index more than 20%) showed a trend of lower change on LF/HF ratio (1.6 vs. 2.4; p= 0.09) than nonregressors. Living-donor graft, baseline LVM, use of antihypertensive drugs, lower change on LF/HF ratio, and lower systolic blood pressure levels were associated with LVM regression in the simple correlation analysis. However, in the logistic regression analysis, only baseline LVM and donor type remained in the model (R(2)=0.35; p=0.0003). Thus, LVH decreased after RT and was related to baseline LVM and living-donor type. However, it is possible that the higher persistence of LVH after RT could be explained at least in part by increase in heart sympathetic activity and use of immunosuppressors.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-006-0238-8