title: The reciprocal interaction between LV remodelling and allograft outcomes in kidney transplant recipients.
abstract: OBJECTIVE
  This study aimed to investigate the incidence and related clinical factors of LV hypertrophy (LVH) regression after kidney transplantation and its effect on graft outcome.
  
  
  METHODS
  Among the 3373 kidney transplant recipients who were enrolled in a multicentre cohort from 1997 to 2012, a total of 767 patients who underwent echocardiography before and after transplantation were included in this study followed for a median of 7.5 years.
  
  
  RESULTS
  LVH regression steadily increased from 7.4% at 1 year to 35.4% at 5 year over the 5-year post-transplantation period. The probability of LVH regression decreased in the patients who received a kidney transplant due to end-stage renal disease of unknown aetiology (p=0.041) or who underwent pretransplant haemodialysis (p=0.020). The probability of LVH regression also decreased as the pretransplant LV mass index (p<0.001) and post-transplant systolic blood pressure increased (p=0.005). Conversely, LVH regression was significantly associated with the highest tertile of the pretransplant haemoglobin level (p=0.029). Furthermore, in the 5th year after transplantation, persistent LVH was independently associated with allograft failure (HR 1.95; 95% CI 1.14 to 3.33; p=0.015) and the LV mass index reliably predicted graft outcome.
  
  
  CONCLUSIONS
  LVH consistently regressed after kidney transplantation in most patients. Persistent LVH, low haemoglobin levels and elevated blood pressure were associated with an increased risk of allograft failure in kidney transplant recipients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung Nam
authors.initials: JN
authors.lastname: An
authors.affiliation: Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jun-Bean
authors.initials: JB
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyung Don
authors.initials: KD
authors.lastname: Yoo
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Park
authors.affiliation: Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Clara Tammy
authors.initials: CT
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Hack-Lyoung
authors.initials: HL
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Duck-Jong
authors.initials: DJ
authors.lastname: Han
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yon Su
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung Pyo
authors.initials: JP
authors.lastname: Lee
mesh_terms: D064591:Allografts / Q000502:physiology; D005260:Female; D006084:Graft Rejection / Q000209:etiology* / Q000503:physiopathology; D006453:Hemoglobinopathies / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology / Q000601:surgery*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020127:Recovery of Function; D012074:Remission Induction; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology*