title: High Left Ventricular Filling Pressure on Doppler Echocardiography Is Associated With Graft Failure and Overall Mortality Following Kidney Transplantation.
abstract: OBJECTIVE
  Although E/e´ is prognostic of mortality in patients with end-stage renal disease (ESED), little is known about the prognostic implications of E/e´ following kidney transplant (KT). The objective of this study was to evaluate whether an elevated E/e´ is associated with graft function, postoperative hemodialysis, and overall mortality in end-stage renal disease patients following KT.
  
  
  METHODS
  A retrospective observational study.
  
  
  METHODS
  Tertiary teaching hospital.
  
  
  METHODS
  In total, 1,045 patients underwent KT at the authors' hospital between January 2006 and December 2013.
  
  
  METHODS
  None.
  
  
  RESULTS
  Patients were divided into groups with an E/e´<15 or≥15, as assessed by preoperative echocardiography (median time from preoperative assessment of echocardiography to surgery: 37 days [IQR: 16-68 days]). Of 1,045 patients, 821 patients (78.6%) had an E/e´<15, and 224 patients (21.4%) had an E/e´≥15. Multivariate analysis indicated that age (odds ratio [OR]: 1.03; 95% confidence interval [CI]: 1.01-1.04, p = 0.001), diabetes mellitus (OR: 2.7; CI: 1.94-3.83, p<0.001), β-blocker (OR: 1.4; CI: 1.03-1.95, p = 0.034), left atrial dimension (OR: 1.07; CI: 1.04-1.11, p<0.001), and left ventricular mass index (OR: 1.02; CI: 1.01-1.03, p<0.001) are predictive of E/e´≥15. After adjustment using inverse probability of treatment weighting, E/e´≥15 also was associated independently with postoperative hemodialysis (OR: 2.0; 95% CI: 1.5-2.6, p<0.001), graft failure (OR: 1.7; 95% CI: 1.4-2.2; p<0.001), and overall mortality (hazard ratio [HR]: 3.2; 95% CI: 2.1-4.8, p<0.001).
  
  
  CONCLUSIONS
  Preoperative E/e´ is a prognostic indicator of overall mortality in ESRD patients undergoing KT.
authors.affiliation: Anesthesiology and Pain Medicine.
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Bang
authors.affiliation: Clinical Epidemiology and Biostatistics.
authors.forename: Jung Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Anesthesiology and Pain Medicine.
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Sang
authors.affiliation: Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Hoon Kim
authors.affiliation: Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
authors.affiliation: Anesthesiology and Pain Medicine. Electronic address: jungol.song@amc.seoul.kr.
authors.forename: Jun-Gol
authors.initials: JG
authors.lastname: Song
authors.affiliation: Anesthesiology and Pain Medicine.
authors.forename: Gyu-Sam
authors.initials: GS
authors.lastname: Hwang
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D005260:Female; D006084:Graft Rejection / Q000209:etiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Doppler echocardiography; end-stage renal disease; kidney transplantation; left ventricular filling pressure