title: Effect of left atrial and ventricular abnormalities on renal transplant recipient outcome-a single-center study.
abstract: BACKGROUND
  Premature cardiovascular (CV) death is the commonest cause of death in renal transplant recipients. Abnormalities of left ventricular (LV) structure (collectively termed uremic cardiomyopathy) and left atrial (LA) dilation, a marker of fluid status and diastolic function, are risk factors for reduced survival in patients with end stage renal disease (ESRD). In the present analysis, we studied the impact of pre-transplant LA and LV abnormalities on survival after successful renal transplantation (RT).
  
  
  METHODS
  One hundred nineteen renal transplant recipients (first transplant, deceased donors) underwent cardiovascular MRI (CMR) as part of CV screening prior to inclusion on the waiting list. Data regarding transplant function and patient survival after transplantation were collected.
  
  
  RESULTS
  Median post-transplant follow-up was 4.3 years (interquartile range (IQR) 1.9, 6.2). During the post-transplant period, 13 patients returned to dialysis after graft failure and 23 patients died with a functioning graft. Survival analyses, censoring for patients returning to dialysis, showed that pre-transplant LV hypertrophy and elevated LA volume were significantly associated with reduced survival after transplantation. Multivariate Cox regression analyses demonstrated that longer waiting time, poorer transplant function, presence of LV hypertrophy and higher LA volume on screening CMR and female sex were independent predictors of death in patients with a functioning transplant.
  
  
  CONCLUSIONS
  Presence of LVH and higher LA volume are significant, independent predictors of death in patients who are wait-listed and proceed with renal transplantation.
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Rajan K
authors.initials: RK
authors.lastname: Patel
authors.affiliation: Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Pennington
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Stevens
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Taylor
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Keith
authors.initials: K
authors.lastname: Gillis
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Rutherford
authors.affiliation: Department of Cardiology, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Johnston
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Alan G
authors.initials: AG
authors.lastname: Jardine
authors.affiliation: BHF Glasgow Cardiovascular Research, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK ; Department of Renal Medicine, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT UK.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Mark
keywords: Left atrial and ventricular function; Outcome; Renal transplantation