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Mitral and Aortic Regurgitation in Patients Undergoing Kidney Transplantation: The Natural Course and Factors Associated With Progression

Authors
 Minjeong Kim  ;  Darae Kim  ;  Juhan Lee  ;  Dae-Young Kim  ;  Jiwon Seo  ;  Iksung Cho  ;  Kyu Ha Huh  ;  Geu-Ru Hong  ;  Jong-Won Ha  ;  Chi Young Shim 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.9 : 809707, 2022-01 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2022-01
Keywords
ESRD ; aortic regurgitation ; kidney transplantation ; left-side valve disease ; mitral regurgitation
Abstract
Background: Valve regurgitation can decrease with resolution of hemodynamic loads on the left ventricle (LV) after kidney transplantation (KT). We aimed to investigate the natural course of left-side valve regurgitation after KT and factors associated with progression.

Methods: Among patients who underwent KT in two tertiary centers, 430 (224 men, mean age 50 ± 13 years) were examined by echocardiography within 3 months before KT and between 6 and 36 months after KT. Mitral regurgitation (MR) and aortic regurgitation (AR) were graded according to the current guidelines. Regression was defined as a decrease in regurgitation by one or more steps, and progression was an increase in one or more steps after KT. Clinical and echocardiographic factors associated with progression of MR and AR were analyzed.

Results: Mild or greater MR was observed in 216 (50%) patients before KT, and mild or greater AR was observed in 99 (23%). During the follow-up period of 23.4 ± 9.9 months, most patients experienced regression or no change in regurgitation after KT, but 34 patients (7.9%) showed MR progression and 37 (8.6%) revealed AR progression. Patients who showed MR progression were more likely to receive a second KT, have mitral annular calcifications, and show a smaller decrease in LV end-systolic dimension. Patients who showed AR progression were more likely to have persistent hypertension after KT, aortic valve calcifications, and a smaller reduction of LV end-systolic dimension.

Conclusions: Risk factors for progression of MR after KT include a second KT, MAC and a smaller decrease in LV end-systolic dimension after KT. Risk factors for progression of AR include valve calcification, persistent hypertension and a smaller decrease in LV end-systolic dimension after KT. Further echocardiographic surveillance and risk factor management after KT are warranted in these patients.
Files in This Item:
T202200487.pdf Download
DOI
10.3389/fcvm.2022.809707
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae-Young(김대영)
Seo, Jiwon(서지원) ORCID logo https://orcid.org/0000-0002-7641-3739
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Ju Han(이주한)
Cho, Ik Sung(조익성)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188028
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