Long-term changes in left ventricular hypertrophy after renal transplantation

Background, Concentric and eccentric left ventricular hypertrophy are commo n progressive disorders in dialysis patients and are associated with cardia c failure and death. Although partial regression of these abnormalities is known to occur during the first posttransplant year, their long-term evolut ion is unknown. Methods. A total of 143 of 433 dialysis patients participating in a long-te rm prospective cohort study received renal transplants. Laboratory paramete rs were assessed monthly. Echocardiography was performed annually. Left ven tricular mass index (LVMI) and cavity volume index were calculated accordin g to standard formulae. Multiple linear regression was used to model change in LVMI as a function of baseline clinical and laboratory variables. Results. LVMI fell from 161 g/m(2) at 1 year to 146 g/m(2) (P=0.009) g/m(2) after 2 years. No further regression was seen in years 3 and 4, Left ventr icular volume index showed similar trends, with a decline from year 1 to ye ar 2 (P=0.05) followed by stabilization in years 3 and 4, Older age, long d uration of hypertension, need for more than one antihypertensive, high puls e pressure in normal-size hearts, and low pulse pressure in dilated hearts were significantly associated with failure of regression of LVMI between th e first and second years (MLR, P<0.000001, r(2)=0.57), Conclusions. Regression of left ventricular hypertrophy continues beyond th e first year after renal transplantation, reaching a nadir at 2 years and p ersisting into the third and fourth posttransplant years. Failure to regres s was associated with older age, hypertension, high pulse pressure in norma l-size hearts and low pulse pressure in dilated hearts.