Patterns of Left Ventricular Geometry and Risk of Cardiovascular Events in a Cohort of Kidney Transplant Patients

Background: Left ventricular hypertrophy is an independent risk factor for cardiovascular morbimortality. There is a clear association between patterns of left ventricular hypertrophy and volume load and myocardial abnormalities in hypertensive patients. The aim of the study is to evaluate the association between pre-transplant echocardiographic left ventricular abnormalities and posttransplant cardiovascular events. Methods: Observational, retrospective cohort study, including 229 consecutive kidney transplant patients between 2010 and 2013. We investigated the association between pre-transplant left ventricular parameters and post-transplant cardiovascular events (Congestive heart failure, acute coronary syndrome, cardiac sudden death, ictus and aortic aneurysm rupture) after adjusting for confounders. Renal outcomes and mortality were analyzed. Results: Concentric hypertrophy was associated with an increased risk of cardiovascular events after kidney transplant (HR 2.334; CI 1.191-4.571 p=0.01). Every 10 g/m2 increase on left ventricular mass index over population mean represents a 9% higher risk for cardiovascular events (HR 1.009 per 1 g/m2 p=0.003). Conclusion: Pre-transplant left ventricular geometry is a useful parameter to assess cardiovascular risk in kidney recipients. Concentric hypertrophy was a powerful predictor of cardiovascular post-transplant events and should be used to identify renal transplant recipients at high cardiovascular risk.