title: Possible correlation among echocardiographic measures, serum brain natriuretic peptide, and angiotensin II levels in hypertensive kidney transplanted children.
abstract: OBJECTIVE
  Ambulatory blood pressure monitoring is the standard for determining patients at risk of hypertension. Left ventricular hypertrophy is common in kidney transplant recipients. We evaluated the correlation between blood pressure measures achieved by ambulatory blood pressure monitoring and conventional (office) methods.
  
  
  METHODS
  This cross-sectional study was done from December 2009 to October 2010 at Alzahra Hospital in Isfahan, Iran. Sixty five participants, 35 kidney transplant recipients under 20 years old, and 30 control subjects of the same age were recruited. Five kidney recipients did not complete the study and were excluded. Blood pressure was measured by ambulatory blood pressure monitoring and conventional methods. Echocardiographic study was done for kidney transplant recipients. Serum brain natriuretic peptide and angiotensin II levels were determined in case and control groups.
  
  
  RESULTS
  Office-recorded systolic and/or diastolic hypertension was observed in 43.4% and 55.3% of patients. According to ambulatory blood pressure monitoring, 86% of kidney transplant recipients had systolic BP load. Left ventricular hypertrophy (defined according to the left ventricular mass index [left ventricular mass index/height]) was seen in 53.3% of the patients. The existence of left ventricular hypertrophy revealed a positive correlation with ambulatory blood pressure monitoring systolic and diastolic night blood pressure and systolic nondipper. Left ventricular mass index showed a positive correlation with brain natriuretic peptide level. Furthermore, the existence of left ventricular hypertrophy was positively correlated with angiotensin II level.
  
  
  CONCLUSIONS
  Only ambulatory blood pressure monitoring systolic and diastolic blood pressures (nondippers) were positively correlated with left ventricular hypertrophy and higher left ventricular mass index. Serum levels of brain natriuretic peptide and angiotensin II had a positive relation with left ventricular hypertrophy. Measuring brain natriuretic peptide and angiotensin II in the clinical setting screens patients at risk of left ventricular hypertrophy.
authors.affiliation: Pediatric Nephrology Department, St Alzahra Hospital, Isfahan, Iran. gheisari@med.mui.ac.ir
authors.forename: Alaleh
authors.initials: A
authors.lastname: Gheissari
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Sabri
authors.forename: Majidreza
authors.initials: M
authors.lastname: Pirpiran
authors.forename: Alireza
authors.initials: A
authors.lastname: Merrikhi
mesh_terms: D000293:Adolescent; D000804:Angiotensin II / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008955:Models, Cardiovascular; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D000804:Angiotensin II; D020097:Natriuretic Peptide, Brain