title: Left ventricular function in children and adults after renal transplantation in childhood.
abstract: BACKGROUND
  Renal transplantation improves left ventricular (LV) function, but cardiovascular mortality remains elevated. The aim of this cross-sectional study was to determine whether subclinical abnormalities of LV longitudinal function also persist in patients who underwent renal transplant in childhood.
  
  
  METHODS
  Conventional and speckle tracking echocardiography was performed in 68 renal transplant recipients (34 children and 34 adults, median 9.8 years (range 2.0-28.4 years) after first transplantation and 68 age- and sex-matched healthy controls.
  
  
  RESULTS
  Mean age at first transplantation was 8.8 ± 4.8 years. Forty-three percent had a pre-emptive transplant. Of the remaining, 70% received haemodialysis and 30% peritoneal dialysis on average for 6.9 months. Thirty-one percent of paediatric and 35% of adult patients had hypertension. LV mass index was increased in adult patients (92 ± 24 vs 75 ± 11 g/m(2), P< 0.01). LV diastolic function and exercise capacity were impaired in both paediatric and adult patients. LV longitudinal peak systolic strain and strain rate were comparable in patients and controls. In multivariate analysis, systolic blood pressure and LV diastolic relaxation were the main covariates of LV peak systolic strain and strain rate (all P < 0.01).
  
  
  CONCLUSIONS
  Patients who underwent renal transplantation in childhood have abnormal LV diastolic function and impaired exercise capacity, despite preserved LV longitudinal systolic deformation.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway. asle.hirth@hotmail.com
authors.forename: Asle
authors.initials: A
authors.lastname: Hirth
authors.forename: Nicola C
authors.initials: NC
authors.lastname: Edwards
authors.forename: Gottfried
authors.initials: G
authors.lastname: Greve
authors.forename: Trine
authors.initials: T
authors.lastname: Tangeraas
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.forename: Kjetil
authors.initials: K
authors.lastname: Lenes
authors.forename: Gunnar
authors.initials: G
authors.lastname: Norgård
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult