In adult transplant recipients, an increase in left ventricular (LV) mass has been linked to cardiac dysfunction. By contrast, this relationship has not been studied in pediatric recipients.

To investigate, Dr. Mark M. Mitsnefes and colleagues, at Cincinnati Children's Hospital Medical Center in Ohio, performed various echocardiographic evaluations during rest and exercise in 29 children with a renal transplant and in 33 healthy controls.

The researchers' findings are reported in the American Journal of Kidney Diseases for April.

Transplant recipients had a significantly greater LV mass index than controls (p < 0.001) and high prevalence of LV hypertrophy (55%), the authors note.

Although contractile reserve was similar in each group, increased LV contractility was noted in transplant recipients (p < 0.001). Moreover, recipients demonstrated abnormal LV relaxation and compliance, both of which were predicted by the LV mass index.

These findings "show impaired cardiac structure and diastolic function in pediatric renal allograft recipients," Dr. Mitsnefes' team states. "Results also suggest that children with a renal transplant and cardiac hypertrophy may be at greater risk for ultimate ventricular systolic dysfunction and congestive heart failure."

Am J Kidney Dis 2004;43:721-726

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