Cardi-Vascular & Metabolic Complications (Videos Available)

Thursday July 05, 2018 from 09:45 to 11:00

Room: N-107/108

620.3 Prevalence and predictors of hypertension among heart transplant recipients: An analysis of Russian National Medical Research Centre of Transplantology and Artificial Organs Registry (Video Available)

Alex O Shevchenko, Russian Federation

Principal
Advanced Heart Failure Centre
National Research Centre of Transplantology and Artificial Organs

Abstract

Prevalence and Predictors of Hypertension among Heart Transplant Recipients: An Analysis of Russian National Medical Research Centre of Transplantology and Artificial Organs registry

Alex Shevchenko2, Nadezhda N Koloskova1, Elena A Nikitina1, Vladislav Orlov3, Sergey V Gautier3.

1Cardiology, Russian National Research Centre of Transplantology and Artificial Organs, Moscow, Russian Federation; 2Advanced Heart Failure Centre, Russian National Research Centre of Transplantology and Artificial Organs, Moscow, Russian Federation; 3Transplant Surgery, Russian National Research Centre of Transplantology and Artificial Organs, Moscow, Russian Federation

Introduction: Post-transplant arterial hypertension (AH) is an important modifiable risk factor for the development of cardiovascular events and renal dysfunction.
Objectives: The study was aimed to assess prevalence and risk factors for the development of AH in heart transplant recipients. 
Patients and methods: End-stage heart failure patients who received cardiac transplant between 01.01.2013 and 31.12.2016 in the Russian National Research Centre of Transplantology and Artificial Organs (Moscow) and survived 3 months were included and followed-up for 999.4±774.3 (108-1587) days. Young patients (<18 y/o) and patients after repeated (n=18) or multi-organ transplantation (n=3) were excluded.
Results: 353 cardiac recipients aged 45.6±1.6 years (64 females and 289 males) were enrolled to the study. AH prevalence was 17.6%, 42.8%, 62.3%, and 71.4% in the pre-transpalnt anamnesis, 3 months, 1 year, and 3+ years after the transplantation, respectively. The risk of developing post-transplant hypertension was independent of age, sex, initial diagnosis, mean tacrolimus levels and the number of acute cellular rejections. Post-transplant AH was significantly related to the initial body mass index (р=0.026), serum creatinine (р<0.001), preexisting hypertension (RR=1.36, р=0.022) and renal failure, as well as donor heart posterior wall thickness (р=0.034), post-transplant dialysis (RR=1.85, р<0.001), and antibody mediated rejection episodes (ОР=1.7, р=0.001).
Conclusions: Hypertension is highly prevalent among our population of cardiac recipients.  Combination of various etiologic mechanisms, multiplex therapy and subjective factors demand the careful individual patient management.  Controlled clinical trials are required to determine target blood pressure levels and assess the impact of various antihypertensive medications on long-term prognosis.



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