title: Reversal of left ventricular dysfunction after renal transplantation.
abstract: We report the cases of four patients with end-stage renal disease and New York Heart Association class III or IV heart failure of nonischemic origin as documented by coronary angiography. Because of left ventricular dysfunction (left ventricular end-diastolic pressure, 23 to 30 mm Hg; ejection fraction, 20% to 35%), all four patients were initially considered poor surgical candidates for renal transplantation. These same four patients became asymptomatic, however, with markedly improved cardiac function (ejection fraction, 43% to 69%) detected as early as 6 and 14 days after renal engraftment. Therefore, there exists a subset of patients with end-stage renal disease in whom congestive heart failure should not be considered a contraindication to renal transplantation. We conclude that some dialysis-dependent patients who manifest symptomatic heart failure of nonischemic origin have a reversible cardiomyopathy and should not be denied renal transplantation.
authors: St. Luke's Episcopal Hospital, Houston, Texas.
authors: R K
authors: RK
authors: Burt
authors: S
authors: S
authors: Gupta-Burt
authors: W N
authors: WN
authors: Suki
authors: C G
authors: CG
authors: Barcenas
authors: J J
authors: JJ
authors: Ferguson
authors: C T
authors: CT
authors: Van Buren
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000503:physiopathology*; D017023:Coronary Angiography; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods; D013318:Stroke Volume / Q000502:physiology