Chronotropic incompetence, echocardiographic abnormalities and exercise intolerance in renal transplant recipients.

Abstract:

BACKGROUND:Chronotropic incompetence (CI) is an independent predictor of cardiovascular events and overall mortality. The prevalence and significance of CI in renal transplant patient has not been examined. METHODS:38 non-heart failure renal transplant recipients were recruited for a transthoracic echocardiogram and treadmill stress test using the modified Bruce protocol. RESULTS:15 patients (39.5%) had CI (defined as failure to reach 85% of the maximum age-predicted heart rate, or <8 0% of predicted heart rate reserve). CI patients had higher left ventricular (LV) mass (216.5 ± 56.1 vs. 183.1 ± 40.0 g, p = 0.04), increased septal wall thickness (11.7 ± 1.4 vs. 10.7 ± 1.1 mm, p = 0.03) and posterior wall thickness (10.9 ± 1.9 vs. 9.5 ± 1.7 mm, p = 0.02). At multivariate analysis, CI was associated with elevated serum creatinine [odds ratio (OR) 1.04, p = 0.03] and increased LV mass (OR 1.03, p = 0.03). CI was associated with shorter exercise duration (3.53 ± 2.20 vs. 8.08 ± 2.34 min, p < 0.01) and lower metabolic equivalents (5.40 ± 2.05 vs. 9.82 ± 2.39, p < 0.01). At multivariate analysis, exercise duration was negatively associated with CI (β = -0.54, p < 0.01). CONCLUSIONS:CI is present in approximately 40% of asymptomatic renal transplant recipients and is associated with reduced exercise tolerance, left ventricular hypertrophy, and worse allograft function .

journal_name

J Nephrol

journal_title

Journal of nephrology

authors

Ma MK,Zuo ML,Yap DY,Mok MM,Kwan LP,Chan GC,Siu DC,Chan TM

doi

10.1007/s40620-014-0091-y

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

451-6

issue

4

eissn

1121-8428

issn

1724-6059

journal_volume

27

pub_type

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