Background: Gated single photon emission computed tomography (SPECT) provides information on myocardial perfusion and left ventricular ejection fraction (LVEF), which correlates with risk of cardiac events in patients with known or suspected coronary artery disease (CAD). We hypothesize that decreased LVEF at time of renal transplant evaluation is an independent risk factor for cardiac death and nonfatal events after transplant.
Methods And Results: A total of 653 recipients of renal allografts between 1998 and 2005 had stress SPECT imaging before transplantation. One hundred and nineteen (18%) patients had left ventricular (LV) systolic dysfunction (LVEF =45%). The patients with LV dysfunction differed from the patients with normal LVEF having a higher proportion of males, smokers, left ventricular hypertrophy, previous left heart catheterization, and higher exposure to dialysis. During a mean follow-up of 3.01+/-1.86 years postrenal transplant, 66 patients died and 67 additional patients experienced at least one nonfatal cardiac-related complication. Patients with LV systolic dysfunction were at considerably higher risk for cardiac complications (hazard ratio [HR] 1.8, P=0.01) and all-cause mortality (HR 2.0, P=0.01) after transplantation. By multivariate analysis, LV systolic dysfunction was associated with a 5-fold increase in the cardiac mortality risk, a 2-fold increase in all-cause mortality risk, and a 70% increase in posttransplant cardiac complications.
Conclusions: Systolic dysfunction is associated with increased risk for overall and cardiac-related death and nonfatal events after renal transplantation, an association independent of ischemic disease.
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http://dx.doi.org/10.1097/01.tp.0000295748.42884.97 | DOI Listing |
Eur J Intern Med
January 2025
Cardiology Department, Hospital Clínico Universitario, Universitat de València, INCLIVA, Valencia, Spain; CIBER Cardiovascular, Madrid, Spain.
Aims: Hypoalbuminemia is frequently found in patients with heart failure (HF), associated with higher morbimortality in acute HF (AHF). Moreover, Carbohydrate Antigen 125 (CA125) is elevated in most of the AHF patients. In this cohort of patients admitted for AHF, our objective was to evaluate the association between hypoalbuminemia and long-term outcomes, including mortality and HF readmissions, stratified by CA125 concentration.
View Article and Find Full Text PDFArch Cardiovasc Dis
December 2024
Service de cardiologie, hôpital Henri-Mondor, 94000 Créteil, France. Electronic address:
Background: Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.
Aim: To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.
BMJ Case Rep
January 2025
Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
A term, healthy infant presented with respiratory distress and severe pulmonary hypertension (PH). With an unclear aetiology and the intent to decrease right ventricular afterload, pulmonary vasodilators were initiated. Follow-up imaging revealed a supravalvular mitral ring as the cause of the PH which resolved after surgical resection of the membrane.
View Article and Find Full Text PDFClin Radiol
November 2024
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China. Electronic address:
Aim: To investigate the relationship between epicardial adipose tissue (EAT) and myocardial strain and the severity of coronary artery disease (CAD), and to evaluate the predictive value of EAT parameters in early left ventricular (LV) diastolic dysfunction.
Materials And Methods: One hundred seventy patients with suspected CAD who underwent both coronary computed tomography angiography and echocardiography were enrolled in 2020. LV global strains were calculated using commercial software.
J Comp Pathol
January 2025
Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, Royal College Street, London NW1 0TU, UK. Electronic address:
Hypertension is a common condition in older cats, often secondary to chronic kidney disease (CKD). Although the heart is one of the organs damaged by hypertension, the pathology of the feline hypertensive (HT) heart has been poorly studied. The aim of this retrospective study was to describe the gross and microscopic pathology of hearts obtained from cats at post-mortem examination and to compare cats diagnosed with hypertension with cats of similar age and kidney function for which antihypertensive treatment was not deemed clinically necessary.
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