Reduced coronary flow reserve in young adults with renal transplant

被引:10
|
作者
Vigano, Sara Maria
Turiel, Maurizio
Martina, Valentina
Meregalli, Elisa
Tornasoni, Livio
De Blasi, Giuseppe
Delfino, Luigl
Edefonti, Alberto
Grillo, Paolo
Procaccio, Mirella
Cusi, Daniele
Ghio, Luciana
机构
[1] Univ Milan, Dept Sci & Biomed Technol, Grad Sch Nephrol, I-20090 Segrate, Italy
[2] Mangiagalli & Regina Elena Fdn, IRCCS Maggiore Hosp, Pediat Nephrol Unit, I-20122 Milan, Italy
[3] IRCCS Multimedia, Hypertens & Prevent Nephrol Unit, I-20099 Sesto san Giovanni, Italy
[4] IRCCS ISt Ortopedico, Cardiol Unit, I-20161 Galeazzi, Italy
[5] Univ Milan, Dept Clin Sci L Sacco, I-20157 Milan, Italy
[6] Mangiagalli & Regina Elena Fdn, IRCCS Maggiore Hosp, I-20122 Milan, Italy
关键词
paediatrics; kidney transplantation; cardiovascular risk; stress echography;
D O I
10.1093/ndt/gfm110
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Some degree of cardiovascular disease should be suspected in young adults who have been paediatric renal transplant recipients also if no systematic data collection is routinely performed in clinical setting. The aim of our work was to evaluate the degree of cardiovascular damage in these young patients, using a minimally invasive technique. We then evaluated coronary flow reserve (CFR) and carotid intima-media thickness (IMT) in 25 patients (13 males, median age 23.7 years). Methods. Coronary flow velocity on the left anterior descending coronary artery was assessed by transthoracic echocardiography, before and after dipyridamole, after standard echocardiography. CFR was compared with that of a small control group (n = 16; median age 25 yrs). Results. In this relatively young sample, mean CFR was 2.8 +/- 0.6 (median 2.75), and half of the patients had reduced coronary reserve (P = 0.01). Mean IMT (0.48 +/- 0.08 mm) was only slightly, though significantly larger compared with the reference standard (P < 0.05) but was significantly thinner in normotensive than in hypertensive patients (0.42 +/- 0.06 vs 0.49 +/- 0.05 mm, P < 0.05). The time on dialysis prior to transplantation, hypertension and age at the time of CFR evaluation affect CFR. IMT did not correlate with CFR. Conclusions: CFR and IMT abnormalities are common in young transplant recipients, in spite of the fact that our paediatric population has much less of the atherosclerotic 'legacy' common to adult patients.
引用
收藏
页码:2328 / 2333
页数:6
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