Prospective assessment of subclinical cardiovascular damage and associated factors in liver transplant recipients
Autor: | Elena Bauer, Bernhard M W Schmidt, Benjamin Maasoumy, Bianca Borchert-Mörlins, Anette Melk, Florian W. R. Vondran, Rizky I. Sugianto, Anika von Wick, Nima Memaran, Elmar Jäckel, Claire Küpper, Jeannine von der Born |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Renal function Blood Pressure 030230 surgery Pulse Wave Analysis Carotid Intima-Media Thickness 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Medicine Humans Prospective Studies Prospective cohort study Pulse wave velocity Subclinical infection Transplantation business.industry Arteriosclerosis medicine.disease Liver Transplantation Blood pressure Intima-media thickness Cardiovascular Diseases Cardiology 030211 gastroenterology & hepatology business Body mass index |
Zdroj: | Transplant international : official journal of the European Society for Organ TransplantationReferences. 34(1) |
ISSN: | 1432-2277 |
Popis: | Cardiovascular (CV) disease plays a major role after liver transplantation (LT). This prospective study assessed subclinical CV damage after LT by measuring pulse wave velocity (PWV), intima-media thickness (IMT) and left-ventricular mass index (LVMI) and characterized associated risk factors. We included 112 patients with a median of 1.8 years after LT (q1-q3 0.9-9.2). Fifty-three percent (n = 59) of patients had ≥2 annual assessments (median follow-up 1.6 years, q1-q3 1.1-2.0), with a total of 195 assessments. We found increased PWV (indicating arteriosclerosis) in 16% (n = 17), elevated IMT in 5% (n = 5; indicating atherosclerosis) and increased LVMI in 25% (n = 24; indicating left-ventricular hypertrophy). A linear mixed model analysis using all 195 assessments revealed that higher age and systolic blood pressure (BP) were associated with higher PWV (β = 0.069, P < 0.001 and β = 0.022, P = 0.005) and higher IMT (β = 0.005, P < 0.001 and β = 0.001, P = 0.029), while higher body mass index was associated with higher IMT (β = 0.004, P = 0.023). Higher systolic BP (β = 0.200, P = 0.034), male sex (β = 8.847, P = 0.031) and lower glomerular filtration rate (β = -0.288, P < 0.001) were associated with higher LVMI. Our data highlight not only the rate of subclinical CV damage in LT patients, but also the impact of classical CV risk factors (such as BP and body mass index) which outweighed LT-related factors. These modifiable risk factors are suitable targets for interventions to reduce CV morbidity in LT patients. |
Databáze: | OpenAIRE |
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