It has been suggested that mTor inhibitors may contribute to the reversal of myocardial hypertrophy after transplantation possibly due to its biological effects like enhanced autophagy. In this preliminary analysis, we have examined the impact of immunosuppression with EVL (n= 16) as compared to MPA (n=17) (all with tacrolimus and steroids) in the echocardiogram findings at the first month (48±19days) and one year (407±64d) after renal transplantation, in elderly (≥60y) recipients. Groups were comparable regarding age (65±3y), race (90% Whites), dialysis, donors, IMC (25±3 kg/m2), prednisone dose and use of ACEi, ARB and other antihypertensive drugs. At 3,6, 9 and 12 months (data shown at 12 mo), the following parameters, for MPA and EVL respectively, were not statistically significant:eGFR (MDRD-4) (46±23 vs 49±16 ml/min/1.73m2), hemoglobin (12.4±2.3 vs 12.5±2.5 g/dL), systolic BP (148±27 vs 145±23 mmHg), diastolic BP (72±14vs 73±11mmHg). Tacrolimus blood levels were lower in the EVL group as per protocol (5.9±2.5 vs 4.1±1.7ng/ml, p=0.02) and EVL blood levelwas 5.1±2.9 ng/ml.At 1 month, 11 patients in each group were classified with increased left ventricular mass index (LVMI) that was higher in the MPA group but not statistically significant(135±27 vs 119±15 g/m2). At one year LVMI decreased (-15%) in the MPA group (115±19 g/m2, p=0.045) but not in the EVL group (122±21g/m2, p=NS). At baseline, 10 and 11 patients, for MPA and EVL groups respectively, presented enlarged interventricular septum thickness (1.35±0.11 vs 1.27±0.90cm, p=NS) that decreased at one year in both, the MPA ( 1.19±0.19, p=0.008, -12%) as well as in the EVL group (1.21±0.83cm, p=0.046, -5%). By logistic regression analysis only systolic BP (OR:1.182, 95%CI 1.00-1.283, p=0.046) and diastolic BP (OR: 1.133, 95%CI 1.00-1.283, p=0.05) were risk factors for increased LVMI at one year. These data show that BP control is the most important factor in reducing LVMI after transplantation in elderly recipients and that the use of mTORi, inone year interval, does not seem to contribute to the reversal of left ventricular hypertrophy in this population.

CITATION INFORMATION: David-Neto E, Agena F, Furtado M, Rodriges A, Andrade J, Lemos F, Paula F. No Impact of One Year of Everolimus, as Compared to MPA, in the Reversal of Left Ventricular Hypertrophy in Elderly Renal Transplant Recipients – Preliminary Data from Then Everold Study. Am J Transplant. 2017;17 (suppl 3).

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