Heart failure

Within a year after kidney transplantation left ventricular ejection fraction (LVEF) was significantly improved in most patients and reached normal values ​​at about 70% of patients. "These data contradict the traditional view that the kidney is an additional burden on the heart with systolic heart failure (HF)," write Dr. Ravinder Wali and his colleagues (University of Maryland Medical Center, Baltimore) in the Journal of the American College of Cardiology.

In addition, we found that improvement in systolic function is more completely than before starting dialysis. The authors observed 103 patients with end-stage renal disease (ESRD), congestive heart failure and LVEF greater than 40% who underwent a kidney transplant. 12 months after surgery to increase the average value of LVEF as compared with baseline values: from 31.6% to 52.2% (p = 0.002). In 69.9% of LVEF reached a level not less than 50%, with a significant improvement in functional class of HF. It is important to note that heart function improved even in the most severe patients. The majority of patients (n = 9; 82%) with an initial LVEF is not higher than 20% of PV had increased to 50% and above. The remaining two (18%) LVEF was 40-49%. Post-transplant LVEF above 50% was the only statistically significant factors associated with reduced risk of death or hospitalization for heart failure: the relative risk of 0.90 (p <0.0001).

"We believe that kidney transplantation should be considered as a method of choice in patients with ESRD and systolic heart failure, as long dialysis can lead to the progression and irreversibility of myocardial dysfunction ... In identifying systolic heart failure in these patients brand viagra online should be as early as possible to perform a kidney transplant, the researchers conclude. In an editorial in the same issue, Dr. Hector Ventura and Dr. Mandeep Mehra (Ochsner Clinic Foundation, New Orleans, Florida) suggest that kidney transplantation leads to improvement of cardiac function is not only due to hemodynamic, and metabolic effects.