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Echocardiography-based score to predict outcome after renal transplantation

Echocardiography-based score to predict outcome after renal transplantation
Echocardiography-based score to predict outcome after renal transplantation
Background: Given the high cardiac mortality of renal transplant recipients, identification of high-risk patients is important to offer appropriate treatment before transplantation.
Aim: To determine patients with high mortality after renal transplantation despite selection according to current criteria.
Methods: Preoperative parameters were collected from 203 renal transplant recipients over a follow-up time of 3.6 (1.9) years. The primary end point was all-cause mortality.
Results: 22 deaths (11%) and 12 cardiac failures (6%) were observed. Non-survivors were older (p0.001), had larger left ventricular end-systolic diameter (LVSD) (p0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p0.001). Left ventricular mass index (p = 0.001), maximal wall thickness (p = 0.006) and the proportion with mitral annular calcification (p = 0.001) were significantly higher in the non-survivors. The risk factors for ischaemic heart disease and exercise test data were not significantly different between the two groups. Four independent predictors of mortality after renal transplantation were identified: age 50 years (p = 0.002), LVESD 3.5 cm (p = 0.002), maximal wall thickness 1.4 cm (p = 0.014) and mitral annular calcification (p = 0.036). The 5-year survival estimates for 0, 1, 2 and 3 prognostic factors were 96%, 86%, 69% and 38%, respectively. No patient had four prognostic factors. In patients 50 years, the 5-year survival estimates for 0, 1 and 2 additional prognostic factors were 73%, 45% and 18%, respectively.
Conclusion: In addition to selection according to current guidelines, age and three conventional echocardiography parameters may further improve risk stratification before renal transplantation.
Abbreviations: LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter
kidney failure, humans, london, left ventricular mass, echocardiography, heart failure, disease, male, female, prospective studies, diagnosis, observer variation
464-469
Sharma, Rajan
aef51420-fc90-49d8-b04c-142214c2961a
Chemla, Eric
0dfc0008-6024-475b-a5f1-8c712eb2d758
Tome, Maite
205921f4-d056-47ce-8f6c-0201becedc83
Mehta, Rajnikant L.
b8db4d9d-053c-4926-9ef0-fa3a8f0e743e
Gregson, Helen
1f44a8f1-809a-4d02-a59d-8353e4f2dd10
Brecker, Stephen J.
73e71800-1551-48cc-895a-457c479de30f
Chang, Rene
4969b74f-3650-4650-a01c-52a9a6a5f4e8
Pellerin, Denis
e11eb3c5-176e-4291-a8b4-3e4336cf477d
Sharma, Rajan
aef51420-fc90-49d8-b04c-142214c2961a
Chemla, Eric
0dfc0008-6024-475b-a5f1-8c712eb2d758
Tome, Maite
205921f4-d056-47ce-8f6c-0201becedc83
Mehta, Rajnikant L.
b8db4d9d-053c-4926-9ef0-fa3a8f0e743e
Gregson, Helen
1f44a8f1-809a-4d02-a59d-8353e4f2dd10
Brecker, Stephen J.
73e71800-1551-48cc-895a-457c479de30f
Chang, Rene
4969b74f-3650-4650-a01c-52a9a6a5f4e8
Pellerin, Denis
e11eb3c5-176e-4291-a8b4-3e4336cf477d

Sharma, Rajan, Chemla, Eric, Tome, Maite, Mehta, Rajnikant L., Gregson, Helen, Brecker, Stephen J., Chang, Rene and Pellerin, Denis (2007) Echocardiography-based score to predict outcome after renal transplantation. Heart, 93 (4), 464-469. (doi:10.1136/hrt.2006.096826).

Record type: Article

Abstract

Background: Given the high cardiac mortality of renal transplant recipients, identification of high-risk patients is important to offer appropriate treatment before transplantation.
Aim: To determine patients with high mortality after renal transplantation despite selection according to current criteria.
Methods: Preoperative parameters were collected from 203 renal transplant recipients over a follow-up time of 3.6 (1.9) years. The primary end point was all-cause mortality.
Results: 22 deaths (11%) and 12 cardiac failures (6%) were observed. Non-survivors were older (p0.001), had larger left ventricular end-systolic diameter (LVSD) (p0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p0.001). Left ventricular mass index (p = 0.001), maximal wall thickness (p = 0.006) and the proportion with mitral annular calcification (p = 0.001) were significantly higher in the non-survivors. The risk factors for ischaemic heart disease and exercise test data were not significantly different between the two groups. Four independent predictors of mortality after renal transplantation were identified: age 50 years (p = 0.002), LVESD 3.5 cm (p = 0.002), maximal wall thickness 1.4 cm (p = 0.014) and mitral annular calcification (p = 0.036). The 5-year survival estimates for 0, 1, 2 and 3 prognostic factors were 96%, 86%, 69% and 38%, respectively. No patient had four prognostic factors. In patients 50 years, the 5-year survival estimates for 0, 1 and 2 additional prognostic factors were 73%, 45% and 18%, respectively.
Conclusion: In addition to selection according to current guidelines, age and three conventional echocardiography parameters may further improve risk stratification before renal transplantation.
Abbreviations: LVEF, left ventricular ejection fraction; LVESD, left ventricular end-systolic diameter

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More information

Published date: 15 September 2007
Keywords: kidney failure, humans, london, left ventricular mass, echocardiography, heart failure, disease, male, female, prospective studies, diagnosis, observer variation

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Local EPrints ID: 62112
URI: http://eprints.soton.ac.uk/id/eprint/62112
PURE UUID: be81d372-d846-4163-8213-3f883670afd1

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Date deposited: 10 Sep 2008
Last modified: 08 Jan 2022 04:03

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Contributors

Author: Rajan Sharma
Author: Eric Chemla
Author: Maite Tome
Author: Rajnikant L. Mehta
Author: Helen Gregson
Author: Stephen J. Brecker
Author: Rene Chang
Author: Denis Pellerin

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