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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 crit... Full description

Journal Title: Heart (British Cardiac Society) 2007, Vol.93 (4), p.464-469
Main Author: Sharma, Rajan
Other Authors: Chemla, Eric , Tome, Maite , Mehta, Rajnikant L , Gregson, Helen , Brecker, Stephen J D , Chang, Rene , Pellerin, Denis
Format: Electronic Article Electronic Article
Language: English
Subjects:
Age
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Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 1355-6037
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title: Echocardiography-based score to predict outcome after renal transplantation
format: Article
creator:
  • Sharma, Rajan
  • Chemla, Eric
  • Tome, Maite
  • Mehta, Rajnikant L
  • Gregson, Helen
  • Brecker, Stephen J D
  • Chang, Rene
  • Pellerin, Denis
subjects:
  • Abridged Index Medicus
  • Adult
  • Age
  • Aged
  • Biological and medical sciences
  • Calcification
  • Cardiac Imaging
  • Cardiac Imaging and Non-Invasive Testing
  • Cardiology. Vascular system
  • Cardiovascular disease
  • Cardiovascular diseases
  • Cardiovascular system
  • Coronary Artery Disease - complications
  • Coronary Artery Disease - diagnostic imaging
  • Coronary Artery Disease - mortality
  • Coronary vessels
  • Echocardiography
  • Echocardiography - standards
  • Female
  • Health risk assessment
  • Heart attacks
  • Heart Failure - etiology
  • Heart Failure - mortality
  • Humans
  • Hypertension
  • Invasive Testing
  • Investigative techniques, diagnostic techniques (general aspects)
  • Kidney diseases
  • Kidney Failure, Chronic - complications
  • Kidney Failure, Chronic - mortality
  • Kidney Failure, Chronic - surgery
  • Kidney Transplantation - diagnostic imaging
  • Kidney Transplantation - mortality
  • Kidneys
  • left ventricular ejection fraction
  • left ventricular end-systolic diameter
  • LVEF
  • LVESD
  • Male
  • Medical imaging
  • Medical prognosis
  • Medical sciences
  • Middle Aged
  • Mortality
  • Non
  • Observer Variation
  • Patient outcomes
  • Patient Selection
  • Patients
  • Peripheral Vascular Diseases - complications
  • Peripheral Vascular Diseases - diagnosis
  • Peritoneal dialysis
  • Population
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Risk factors
  • Studies
  • Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
  • Surgery of the urinary system
  • Transplantation
  • Transplants & implants
  • Treatment Outcome
  • Ultrasonic investigative techniques
  • Usage
  • Variables
ispartof: Heart (British Cardiac Society), 2007, Vol.93 (4), p.464-469
description: 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 (p⩽0.001), had larger left ventricular end-systolic diameter (LVSD) (p⩽0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p⩽0.001). 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.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleEchocardiography-based score to predict outcome after renal transplantation
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creatorSharma, Rajan ; Chemla, Eric ; Tome, Maite ; Mehta, Rajnikant L ; Gregson, Helen ; Brecker, Stephen J D ; Chang, Rene ; Pellerin, Denis
creatorcontribSharma, Rajan ; Chemla, Eric ; Tome, Maite ; Mehta, Rajnikant L ; Gregson, Helen ; Brecker, Stephen J D ; Chang, Rene ; Pellerin, Denis
descriptionBackground: 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 (p⩽0.001), had larger left ventricular end-systolic diameter (LVSD) (p⩽0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p⩽0.001). 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.
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1EISSN: 1468-201X
2DOI: 10.1136/hrt.2006.096826
3PMID: 16980518
languageeng
publisherLondon: BMJ Publishing Group Ltd and British Cardiovascular Society
subjectAbridged Index Medicus ; Adult ; Age ; Aged ; Biological and medical sciences ; Calcification ; Cardiac Imaging ; Cardiac Imaging and Non-Invasive Testing ; Cardiology. Vascular system ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular system ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary vessels ; Echocardiography ; Echocardiography - standards ; Female ; Health risk assessment ; Heart attacks ; Heart Failure - etiology ; Heart Failure - mortality ; Humans ; Hypertension ; Invasive Testing ; Investigative techniques, diagnostic techniques (general aspects) ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - surgery ; Kidney Transplantation - diagnostic imaging ; Kidney Transplantation - mortality ; Kidneys ; left ventricular ejection fraction ; left ventricular end-systolic diameter ; LVEF ; LVESD ; Male ; Medical imaging ; Medical prognosis ; Medical sciences ; Middle Aged ; Mortality ; Non ; Observer Variation ; Patient outcomes ; Patient Selection ; Patients ; Peripheral Vascular Diseases - complications ; Peripheral Vascular Diseases - diagnosis ; Peritoneal dialysis ; Population ; Predictive Value of Tests ; Prospective Studies ; Risk Assessment ; Risk factors ; Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Transplantation ; Transplants & implants ; Treatment Outcome ; Ultrasonic investigative techniques ; Usage ; Variables
ispartofHeart (British Cardiac Society), 2007, Vol.93 (4), p.464-469
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1Chemla, Eric
2Tome, Maite
3Mehta, Rajnikant L
4Gregson, Helen
5Brecker, Stephen J D
6Chang, Rene
7Pellerin, Denis
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0Echocardiography-based score to predict outcome after renal transplantation
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descriptionBackground: 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 (p⩽0.001), had larger left ventricular end-systolic diameter (LVSD) (p⩽0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p⩽0.001). 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.
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0Abridged Index Medicus
1Adult
2Age
3Aged
4Biological and medical sciences
5Calcification
6Cardiac Imaging
7Cardiac Imaging and Non-Invasive Testing
8Cardiology. Vascular system
9Cardiovascular disease
10Cardiovascular diseases
11Cardiovascular system
12Coronary Artery Disease - complications
13Coronary Artery Disease - diagnostic imaging
14Coronary Artery Disease - mortality
15Coronary vessels
16Echocardiography
17Echocardiography - standards
18Female
19Health risk assessment
20Heart attacks
21Heart Failure - etiology
22Heart Failure - mortality
23Humans
24Hypertension
25Invasive Testing
26Investigative techniques, diagnostic techniques (general aspects)
27Kidney diseases
28Kidney Failure, Chronic - complications
29Kidney Failure, Chronic - mortality
30Kidney Failure, Chronic - surgery
31Kidney Transplantation - diagnostic imaging
32Kidney Transplantation - mortality
33Kidneys
34left ventricular ejection fraction
35left ventricular end-systolic diameter
36LVEF
37LVESD
38Male
39Medical imaging
40Medical prognosis
41Medical sciences
42Middle Aged
43Mortality
44Non
45Observer Variation
46Patient outcomes
47Patient Selection
48Patients
49Peripheral Vascular Diseases - complications
50Peripheral Vascular Diseases - diagnosis
51Peritoneal dialysis
52Population
53Predictive Value of Tests
54Prospective Studies
55Risk Assessment
56Risk factors
57Studies
58Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
59Surgery of the urinary system
60Transplantation
61Transplants & implants
62Treatment Outcome
63Ultrasonic investigative techniques
64Usage
65Variables
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titleEchocardiography-based score to predict outcome after renal transplantation
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13Coronary Artery Disease - diagnostic imaging
14Coronary Artery Disease - mortality
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16Echocardiography
17Echocardiography - standards
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19Health risk assessment
20Heart attacks
21Heart Failure - etiology
22Heart Failure - mortality
23Humans
24Hypertension
25Invasive Testing
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1Correspondence to:
 Dr D Pellerin
 The Heart Hospital, 16–18 Westmoreland Street, London W1G 8PH, UK; denis.pellerin@uclh.nhs.uk
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abstractBackground: 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 (p⩽0.001), had larger left ventricular end-systolic diameter (LVSD) (p⩽0.001) and end-diastolic diameter (p = 0.002), and lower ejection fraction (p⩽0.001). 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.
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