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Effect of kidney transplantation on left ventricular systolic dysfunction and congestive heart failure in patients with end-stage renal disease

Ravinder K. Wali, MD^_*,_*, Gregory S. Wang, MD^,¶, Stephen S. Gottlieb, MD, Lavanya Bellumkonda, MD^_*,¶, Riple Hansalia, MD^,¶, Emilio Ramos, MD^_*, Cinthia Drachenberg, MD^||, John Papadimitriou, MD^||, Meredith A. Brisco, MD^,¶, Steve Blahut, PhD^_*, Jeffrey C. Fink, MD^_*, Michael L. Fisher, MD^,¶, Stephen T. Bartlett, MD and Matthew R. Weir, MD^_*

^_* Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Division of Transplant Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland
^|| Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
^¶ Current author affiliations: Dr. Wang, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia; Dr. Bellumkonda, Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut; Dr. Hansalia, Zena and Michael A. Weiner Cardiovascular Institute, New York, New York; Dr. Fisher, Department of Cardiology, Kaiser Permanente, Denver, Colorado; and Dr. Brisco, Department of Internal Medicine, Barnes-Jewish Hospital, St. Louis, Missouri

View larger version (25K): [in a new window]   Figure 1 Kaplan-Meier analysis of survival plots for death in the post-transplant period (after first six months after transplantation). Persistence of left ventricular ejection fraction (LVEF) <50% in the post-transplant period was associated with an eight-fold increase in the rate of death. The number (%) of deaths in patients with post-transplant LVEF >50%: 6 (8%) of 72; in patients with post-transplant LVEF >40% but <50%: 10 (62%) of 16; and in patients with post-transplant LVEF <40%: 9 (60%) of 15. p < 0.0001 by the log-rank test.

View larger version (50K): [in a new window]   Figure 2 Pretransplant (while on dialysis) and post-transplant left ventricular ejection fraction (LVEF) in different subgroups of patients. All = all patients; CAD = pretransplant coronary artery disease; CABG = pretransplant coronary artery bypass grafting; DM = pretransplant diabetes mellitus (type 1 or 2); PTCA = pretransplant percutaneous transluminal coronary angioplasty. Error bars = standard deviations.