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The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

 Eun Jung Kim  ;  Bon-Nyeo Koo  ;  So Yeon Kim  ;  Kyu Ha Huh  ;  Soojeong Kang  ;  Yong Seon Choi 
 Yonsei Medical Journal, Vol.60(3) : 291-297, 2019 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adult ; Diastole/physiology* ; Female ; Humans ; Kidney Transplantation/adverse effects* ; Linear Models ; Male ; Mitral Valve/physiopathology ; Multivariate Analysis ; Perioperative Care* ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left/physiology
Kidney transplantation ; diastolic function ; end-stage renal disease (ESRD)
PURPOSE: Cardiac changes in end-stage renal disease are the most common causes of death after kidney transplantation (KT). Chronic kidney disease presents a major risk factor for the development and progression of diastolic dysfunction. The purpose of this study was to identify the association between changes in left ventricular (LV) diastolic function and perioperative clinical factors in patients with preserved ejection fraction following KT. MATERIALS AND METHODS: We reviewed 115 patients who underwent KT between January 2011 and December 2015 with both preand post-transplant echocardiograms; patients with LV systolic dysfunction were excluded. LV diastolic function was measured using the ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e'). RESULTS: Patients with normal pre-operative LV systolic function (n=97) showed improvement in E/e' after KT (11.9±4.4 to 10.5±3.8, p=0.023). Additionally, post-KT estimated glomerular filtration ratio was associated with changes in E/e' (odds ratio, -0.056; 95% confidence interval, -0.014 to -0.007; p=0.026). Among patients with preexisting diastolic dysfunction (20/97 patients), the amount of intraoperative fluid administration was related to E/e' changes (odds ratio, 0.003; 95% confidence interval, 0.000 to 0.005; p=0.029). CONCLUSION: KT is associated with improved diastolic function. Post-KT renal function was significantly related to changes in LV diastolic function. The amount of intraoperative fluid was a risk factor for worsening diastolic function after KT in patients with preexisting diastolic dysfunction.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
구본녀(Koo, Bon-Nyeo) ORCID logo https://orcid.org/0000-0002-3189-1673
김소연(Kim, So Yeon) ORCID logo https://orcid.org/0000-0001-5352-157X
김은정(Kim, Eun Jung) ORCID logo https://orcid.org/0000-0002-5693-1336
최용선(Choi, Yong Seon) ORCID logo https://orcid.org/0000-0002-5348-864X
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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