Cardiac disease in renal transplant recipients

Rigatto, Claudio (2001) Cardiac disease in renal transplant recipients. Masters thesis, Memorial University of Newfoundland.

[English] PDF (Migrated (PDF/A Conversion) from original format: (application/pdf)) - Accepted Version Available under License - The author retains copyright ownership and moral rights in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission. Download (11MB) [English] PDF - Accepted Version Available under License - The author retains copyright ownership and moral rights in this thesis. Neither the thesis nor substantial extracts from it may be printed or otherwise reproduced without the author's permission. (Original Version)

Abstract

Cardiac disease (CVD) is a major cause of morbidity in renal transplant recipients (RTR). The relative importance of traditional vs. transplant-related risk factors, however, remains controversial, while the impact of LV disorders has not been well studied. We conducted two cohort studies to examine the incidence, determinants, and outcomes of LV disorders in RTR, and to compare the relative importance of traditional vs. transplant-related risk factors. In Study One (sequential echocardiograms in a prospective cohort of RTR), LV hypertrophy regressed over the first two post transplant years and thereafter remained stable. Older age and hypertension predicted failure to regress. In Study Two (a retrolective cohort study of 473 RTR), congestive heart failure (CHF) was as common and as adverse a morbid event as ischemic heart disease (IHD). Age, diabetes, gender, blood pressure and anemia were the dominant predictors of CHF, while age, diabetes, gender, blood pressure and cholesterol were the dominant risk factors for IHD. The determinants of de novo IHD in RTR were similar to those in general population, whereas the determinants of LV disorders are similar to those in chronic renal insufficiency. Transplant associated variables, with the exception of anemia, were not strongly associated with outcomes. -- Keywords: Renal transplantation; left ventricular hypertrophy; cardiovascular disease; anemia; cohort study.

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