Background Asymptomatic left ventricular hypertrophy (LVH) is highly prevalent and associated with adverse outcome in renal transplant recipients (RTRs). Nonetheless, there are currently no available studies analyzing the effect of LVH regression on solid clinical endpoints in these patients.

Methods This study is the extension of two RCTs aimed at assessing the effect of active intervention on post-transplant LVH in RTRs. We evaluated the incidence of a composite of death, and any cardiovascular (CV) or renal event in the 46 RTRs randomized to active therapy for post-transplant LVH and in 54 controls.

ResultsLVMi reduction was observed in 60 patients.

During a 8.4±3.5 year follow-up 8 deaths, 18 CV, and 6 renal events occurred in the entire cohort. Multivariable analysis showed that age (HR 1.07, 95% CI 1.03-1.12 each 1 year, P=0.002) and LVH regression (HR 0.42, 95% CI 0.22-0.87, P=0.019) were significant predictors of the composite endpoint. Kaplan-Meier estimates showed better survival rates in patients in whom actual LVH regression was achieved (P<0.001, log-rank test). Age (HR 1.09, 95%CI 1.03-1.15 each 1 year, P=0.004), better graft function (HR 0.95, 95% CI 0.91-0.99 each 1 mL/min/1.73 m² increase in eGFR, P=0.03) and LVH regression (HR 0.41, 95% CI 0.22-0.79, P=0.01) were significant predictors of the CV endpoint. Patients with LVMi decrease also showed better cardiac event-free survival (P=0.0022, log-rank test).

Conclusions This is the first study to demonstrate that LVH regression, regardless of the therapeutic strategy adopted to achieve it, portends better long-term clinical outcome in RTRs.

CITATION INFORMATION: Paoletti E, Bellino D, Marsano L, Russo R, Masarino F, Garibotto G. Regression of Asymptomatic Cardiomyopathy and Clinical Outcome of Renal Transplant Recipients: Long-Term Extension of Two Randomized Controlled Trials. Am J Transplant. 2016;16 (suppl 3).

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