title: Cardiac dysfunction after renal transplantation; incomplete resolution in pediatric population.
abstract: BACKGROUND
  Long-term data of cardiac function after renal transplantation (RT) are limited, especially in children. Thus, we evaluated the status of left ventricular hypertrophy and various indices of left ventricular (LV) function in pediatric RT patients.
  
  
  METHODS
  Blood pressure, serum biochemical profiles, electrocardiogram, and echocardiogram of 32 pediatric patients (mean age, 15.5+/-4.4 years) who underwent RT 5.1+/-2.5 years before and 29 body surface area-matched control subjects were studied.
  
  
  RESULTS
  Repolarization abnormalities shown on electrocardiogram of pre-RT patients improved significantly after RT (QTc dispersion 50.8+/-37.3 to 37.4+/-11.9 msec, P=0.009). Left ventricular hypertrophy with increased LV mass index of pre-RT patients regressed remarkably after RT (LV mass index 120.9+/-40.5 to 69.2+/-14.5 g/m2, P<0.001); still, LV mass was significantly higher in RT patients than the controls (54.0+/-9.6 g/m2, P<0.001). Compared with the controls, the RT patients showed diastolic dysfunction (lower E/A ratio and higher isovolumic relaxation time) and lower myocardial performance (higher LV Tei index and weaker strain pattern). Patients who had shorter duration of non-RT renal replacement therapy showed better LV function (lower LV Tei index and stronger strain pattern) in the long-term follow-up.
  
  
  CONCLUSIONS
  Because cardiac dysfunction did not resolve after RT in pediatric population, regular evaluation for cardiovascular function after RT is required. Early RT may also be beneficial to global LV performance after RT.
authors.affiliation: Department of Pediatrics, Seoul National University Hospital, Jongno-Gu, Seoul, South Korea.
authors.forename: Gi Beom
authors.initials: GB
authors.lastname: Kim
authors.forename: Bo Sang
authors.initials: BS
authors.lastname: Kwon
authors.forename: Hee Gyung
authors.initials: HG
authors.lastname: Kang
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Ha
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Ha
authors.forename: Chung Il
authors.initials: CI
authors.lastname: Noh
authors.forename: Jung Yun
authors.initials: JY
authors.lastname: Choi
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Yun
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Bae
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002648:Child; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000502:physiology* / Q000706:statistics & numerical data; D007723:Korea / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology*; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult