Reduced coronary flow reserve in young adults with renal transplant.
BACKGROUND
Some degree of cardiovascular disease should be suspected in young adults who have been paediatric renal transplant recipients also if no systematic data collection is routinely performed in clinical setting. The aim of our work was to evaluate the degree of cardiovascular damage in these young patients, using a minimally invasive technique. We then evaluated coronary flow reserve (CFR) and carotid intima-media thickness (IMT) in 25 patients (13 males, median age 23.7 years).


METHODS
Coronary flow velocity on the left anterior descending coronary artery was assessed by transthoracic echocardiography, before and after dipyridamole, after standard echocardiography. CFR was compared with that of a small control group (n = 16; median age 25 yrs).


RESULTS
In this relatively young sample, mean CFR was 2.8 +/- 0.6 (median 2.75), and half of the patients had reduced coronary reserve (P = 0.01). Mean IMT (0.48 +/- 0.08 mm) was only slightly, though significantly larger compared with the reference standard (P < 0.05) but was significantly thinner in normotensive than in hypertensive patients (0.42 +/- 0.06 vs 0.49 +/- 0.05 mm, P < 0.05). The time on dialysis prior to transplantation, hypertension and age at the time of CFR evaluation affect CFR. IMT did not correlate with CFR.


CONCLUSIONS
CFR and IMT abnormalities are common in young transplant recipients, in spite of the fact that our paediatric population has much less of the atherosclerotic 'legacy' common to adult patients.
Viganò
Sara Maria
SM
Graduate School of Nephrology, Department of Sciences and Biomedical Technologies, University of Milano, Via Fratelli Cervi 93, 20090 Segrate, Italy. saramaria.vigano@studenti.unimi.it
Turiel
Maurizio
M
Martina
Valentina
V
Meregalli
Elisa
E
Tomasoni
Livio
L
De Blasio
Giuseppe
G
Delfino
Luigi
L
Edefonti
Alberto
A
Grillo
Paolo
P
Procaccio
Mirella
M
Cusi
Daniele
D
Ghio
Luciana
L
D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D003326:Coronary Circulation; D004452:Echocardiography / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
D000959:Antihypertensive Agents