Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2043
Title: Regression of cardiac growth in kidney transplant recipients using anti-m-TOR drugs plus RAS blockers: a controlled longitudinal study.
Authors: 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
metadata.dc.contributor.authoraffiliation: [Hernández,D; Ruiz-Esteban,P; Burgos,D; Palma,E; Cabello,M; González-Molina,M] Department of Nephrology, Carlos Haya University Hospital and IBIMA, Malaga, Spain. [Gaitán,D; De Mora,M] Department of Cardiology and Radiology, Carlos Haya University Hospital and IBIMA, Malaga, Spain. [Briceño,E] Department of Radiology, Carlos Haya University Hospital and IBIMA, Malaga, Spain. [Mazuecos,A; Collantes,R] Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain.
Keywords: 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
metadata.dc.subject.mesh: 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
Issue Date: 23-Apr-2014
Publisher: BioMed Central
Citation: 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
Abstract: 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.
Description: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/2043
metadata.dc.relation.publisherversion: http://www.biomedcentral.com/1471-2369/15/65/abstract
metadata.dc.identifier.doi: 10.1186/1471-2369-15-65
ISSN: 1471-2369 (Online)
Appears in Collections:01- Artículos - Hospital Puerta del Mar
01- Artículos - Hospital Regional de Málaga
01- Artículos - IBIMA. Instituto de Investigación Biomédica de Málaga

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