%0 Journal Article
%A Hernández, Domingo
%A Ruiz-Esteban, Pedro
%A Gaitán, Daniel
%A Burgos, Dolores
%A Mazuecos, Auxiliadora
%A Collantes, Rocío
%A Briceño, Eva
%A Palma, Eulalia
%A Cabello, Mercedes
%A González-Molina, Miguel
%A De Mora, Manuel
%T Regression of cardiac growth in kidney transplant recipients using anti-m-TOR drugs plus RAS blockers: a controlled longitudinal study.
%D 2014
%U http://hdl.handle.net/10668/2043
%X BACKGROUNDLeft 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.METHODSWe 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.RESULTSNineteen 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).CONCLUSIONSSwitching 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.
%K Everolimus
%K Left ventricular hupertrophy
%K Renin-angiotensis blockers
%K Sirolimus
%K Kidney transplantation
%K Inhibidores de la enzima convertidora de angiotensina
%K Farmacoterapia combinada
%K Hipertrofia ventricular izquierda
%K Inmunosupresores
%K Trasplante de riñón
%K Inhibidores de proteínas cinasas
%K TOR serina-treonina cinasas
%K Resultado del tratamiento
%K Antagonistas de receptores de angiotensina
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