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. 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.
Guízar-Mendoza
Juan Manuel
JM
Unidad de Investigación Epidemiológica UMAE 48 del Instituto Mexicano del Seguro Social, Lopez Mateos e Insurgentes s/n Colonia Paraísos, Z.C. 37320, León, Mexico.
Amador-Licona
Norma
N
Lozada
Efrén Edgard
EE
Rodriguez
Leticia
L
Gutiérrez-Navarro
María
M
Dubey-Ortega
Luis Antonio
LA
Trejo-Bellido
José
J
Encarnación
José de Jesús
Jde J
Ruiz-Jaramillo
María De la Cruz
Mde L
D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000294:innervation* / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000502:physiology*
D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents