Regression of cardiac growth in kidney transplant recipients using anti-m-TOR drugs plus RAS blockers: a controlled longitudinal study.


Autoria(s): Hernández, Domingo; Ruiz-Esteban, Pedro; Gaitán, Daniel; Burgos, Dolores; Mazuecos, Auxiliadora; Collantes, Rocío; Briceño, Eva; Palma, Eulalia; Cabello, Mercedes; González-Molina, Miguel; De Mora, Manuel
Data(s)

04/11/2015

04/11/2015

23/04/2014

Resumo

BACKGROUND Left ventricular hypertrophy (LVH) is common in kidney transplant (KT) recipients. LVH is associated with a worse outcome, though m-TOR therapy may help to revert this complication. We therefore conducted a longitudinal study to assess morphological and functional echocardiographic changes after conversion from CNI to m-TOR inhibitor drugs in nondiabetic KT patients who had previously received RAS blockers during the follow-up. METHODS We undertook a 1-year nonrandomized controlled study in 30 non-diabetic KT patients who were converted from calcineurin inhibitor (CNI) to m-TOR therapy. A control group received immunosuppressive therapy based on CNIs. Two echocardiograms were done during the follow-up. RESULTS Nineteen patients were switched to SRL and 11 to EVL. The m-TOR group showed a significant reduction in LVMi after 1 year (from 62 ± 22 to 55 ± 20 g/m2.7; P=0.003, paired t-test). A higher proportion of patients showing LVMi reduction was observed in the m-TOR group (53.3 versus 29.3%, P=0.048) at the study end. In addition, only 56% of the m-TOR patients had LVH at the study end compared to 77% of the control group (P=0.047). A significant change from baseline in deceleration time in early diastole was observed in the m-TOR group compared with the control group (P=0.019). CONCLUSIONS Switching from CNI to m-TOR therapy in non-diabetic KT patients may regress LVH, independently of blood pressure changes and follow-up time. This suggests a direct non-hemodynamic effect of m-TOR drugs on cardiac mass.

Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't;

This study was supported by grant PI-0499/2009 from the Consejería de Salud del Gobierno de Andalucía and, in part, by the Spanish Ministry of Science and Innovation (MICINN) (Grant no. PI10/01020) from the Instituto de Salud Carlos III, RETIC, REDinREN RD12/0021/0015.

Identificador

Hernández D, Ruiz-Esteban P, Gaitán D, Burgos D, Mazuecos A, Collantes R, et al. Regression of cardiac growth in kidney transplant recipients using anti-m-TOR drugs plus RAS blockers: a controlled longitudinal study. BMC Nephrol. 2014; 15:65

1471-2369 (Online)

PMC4005821

http://hdl.handle.net/10668/2043

24755192

10.1186/1471-2369-15-65

Idioma(s)

en

Publicador

BioMed Central

Relação

BMC Nephrology

http://www.biomedcentral.com/1471-2369/15/65/abstract

Direitos

Acceso abierto

Palavras-Chave #Everolimus #Left ventricular hupertrophy #Renin-angiotensis blockers #Sirolimus #Kidney transplantation #Inhibidores de la enzima convertidora de angiotensina #Farmacoterapia combinada #Hipertrofia ventricular izquierda #Inmunosupresores #Trasplante de riñón #Inhibidores de proteínas cinasas #TOR serina-treonina cinasas #Resultado del tratamiento #Antagonistas de receptores de angiotensina #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Protease Inhibitors::Angiotensin-Converting Enzyme Inhibitors #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy, Combination #Medical Subject Headings::Check Tags::Female #Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans #Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Pathological Conditions, Anatomical::Hypertrophy::Cardiomegaly::Hypertrophy, Left Ventricular #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Kidney Transplantation #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies #Medical Subject Headings::Check Tags::Male #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Protein Kinase Inhibitors #Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Intracellular Signaling Peptides and Proteins::TOR Serine-Threonine Kinases #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Angiotensin Receptor Antagonists
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Artículo