PMID- 15808763
OWN - NLM
STAT- MEDLINE
DCOM- 20050422
LR  - 20220311
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 45
IP  - 7
DP  - 2005 Apr 5
TI  - Effect of kidney transplantation on left ventricular systolic dysfunction and 
      congestive heart failure in patients with end-stage renal disease.
PG  - 1051-60
AB  - OBJECTIVES: We examined the impact of kidney transplantation on left ventricular 
      ejection fraction (LVEF) in end-stage renal disease (ESRD) patients with 
      congestive heart failure (CHF). BACKGROUND: The ESRD patients with decreased LVEF 
      and a poor New York Heart Association (NYHA) functional class are not usually 
      referred for transplant evaluations, as they are considered to be at increased 
      risk of cardiac and surgical complications. METHODS: Between June 1998 and 
      November 2002, 103 recipients with LVEF < or =40% and CHF underwent kidney 
      transplantation. The LVEF was re-assessed by radionuclide ventriculography 
      gated-blood pool (MUGA) scan at six and 12 months and at the last follow-up 
      during the post-transplant period. RESULTS: Mean pre-transplant LVEF% increased 
      from 31.6 +/- 6.7 (95% confidence interval [CI] 30.3 to 32.9) to 52.2 +/- 12.0 
      (95% CI 49.9 to 54.6, p = 0.002) at 12 months after transplantation. There was no 
      perioperative death. After transplantation, 69.9% of patients achieved LVEF > or 
      =50% (normal LVEF). A longer duration of dialysis (in months) before 
      transplantation decreased the likelihood of normalization of LVEF in the 
      post-transplant period (odds ratio 0.82, 95% CI 0.74 to 0.91; p < 0.001). The 
      NYHA functional class improved significantly in those with normalization of LVEF 
      (p = 0.003). After transplantation, LVEF >50% was the only significant factor 
      associated with a lower hazard for death or hospitalizations for CHF (relative 
      risk 0.90, 95% CI 0.86 to 0.95; p < 0.0001). CONCLUSIONS: Kidney transplantation 
      in ESRD patients with advanced systolic heart failure results in an increase in 
      LVEF, improves functional status of CHF, and increases survival. To abrogate the 
      adverse effects of prolonged dialysis on myocardial function, ESRD patients 
      should be counseled for kidney transplantation as soon as the diagnosis of 
      systolic heart failure is established.
FAU - Wali, Ravinder K
AU  - Wali RK
AD  - Division of Nephrology, Department of Medicine, University of Maryland School of 
      Medicine, 22 South Greene Street, Baltimore, MD 21201, USA. 
      rwali@medicine.umaryland.edu
FAU - Wang, Gregory S
AU  - Wang GS
FAU - Gottlieb, Stephen S
AU  - Gottlieb SS
FAU - Bellumkonda, Lavanya
AU  - Bellumkonda L
FAU - Hansalia, Riple
AU  - Hansalia R
FAU - Ramos, Emilio
AU  - Ramos E
FAU - Drachenberg, Cinthia
AU  - Drachenberg C
FAU - Papadimitriou, John
AU  - Papadimitriou J
FAU - Brisco, Meredith A
AU  - Brisco MA
FAU - Blahut, Steve
AU  - Blahut S
FAU - Fink, Jeffrey C
AU  - Fink JC
FAU - Fisher, Michael L
AU  - Fisher ML
FAU - Bartlett, Stephen T
AU  - Bartlett ST
FAU - Weir, Matthew R
AU  - Weir MR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2005 Apr 5;45(7):1061-3. PMID: 15808764
MH  - Female
MH  - Heart Failure/*complications/physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Kidney/physiopathology
MH  - Kidney Failure, Chronic/complications/mortality/physiopathology/*surgery
MH  - *Kidney Transplantation
MH  - Male
MH  - Maryland/epidemiology
MH  - Middle Aged
MH  - Radionuclide Ventriculography
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Systole
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*physiopathology
EDAT- 2005/04/06 09:00
MHDA- 2005/04/23 09:00
CRDT- 2005/04/06 09:00
PHST- 2004/08/25 00:00 [received]
PHST- 2004/11/23 00:00 [revised]
PHST- 2004/11/29 00:00 [accepted]
PHST- 2005/04/06 09:00 [pubmed]
PHST- 2005/04/23 09:00 [medline]
PHST- 2005/04/06 09:00 [entrez]
AID - S0735-1097(04)02592-6 [pii]
AID - 10.1016/j.jacc.2004.11.061 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2005 Apr 5;45(7):1051-60. doi: 10.1016/j.jacc.2004.11.061.