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Daily blood pressure control is not sufficient to regress cardiac hypertrophy and dysfunction: A bi-ventricular tissue Doppler echocardiographic study


Dr Saime Paydas, Division of Nephrology, Department of Internal Medicine, School of Medicine, Cukurova University, 01330, Balcali-Adana, Turkey. Email:


Background:  Hypertension is one of the main causes of cardiovascular complications leading to death and allograft dysfunction. The aim of this study was to determine the relationship between the levels of 24 h blood pressure and left ventricular mass index (LVMI) and bi-ventricular tissue Doppler echocardiographic measurements in renal transplant recipients (RTxr) and dialysis patients.

Methods:  In this cross-sectional study, we evaluated 32 non-diabetic renal transplant recipients (GI) and 18 patients with end-stage renal insufficiency who underwent haemodialysis (GII).

Results:  The mean follow-up periods were 49.16 ± 38.02 and 56.83 ± 34.14 months in GI and GII, respectively. There were no differences for age, gender, daytime systolic–diastolic blood pressures and loads among the groups. The mean night-time systolic–diastolic blood pressures in GI and GII were 119.77 ± 17.41–77.34 ± 14.46 and 120.23 ± 25.53–76.17 ± 18.77 mmHg, respectively (P I–II = 0.453–0.72). The mean night-time systolic blood pressure loads in GI and GII were 4.92 ± 7.77 and 6.10 ± 8.16%, respectively (P I–II = 0.68). The mean night-time diastolic blood pressure loads were 7.79 ± 7.83 and 8.02 ± 8.28% in GI and GII, respectively (P I–II = 0.55). The mean levels of LVMI in GI and GII were 115.81 ± 28.07 and 128.06 ± 65.72 g/m2, respectively (P I–II = 0.85). The mean levels of left ventricular Em/Am by tissue Doppler echocardiography were 1.13 ± 0.40 and 0.90 ± 0.29, respectively (P I–II = 0.127), while the mean levels of right ventricular Em/Am were 0.89 ± 0.37 and 0.88 ± 0.26, respectively (P I–II = 0.50).

Conclusion:  After renal transplantation, LVMI and bi-ventricular diastolic dysfunction were not regressed. Daytime and night-time blood pressures and loads were similar in the two groups. We can say that well-controlled daytime blood pressure and load is not sufficient to decrease cardiovascular risk in RTxr. Also, it is important to control of night-time blood pressure and load to reduce cardiovascular risk in RTxr. RTxr should be monitored with ambulatory blood pressure monitoring and tissue Doppler echocardiography.