Summary Cardiovascular mortality in kidney transplant recipients has shown to be substantially elevated particularly in the first year of transplantation. Complex ventricular arrhythmia (VA) has been pointed as one of the etiologies of sudden death. The aim of this study was to evaluate the prevalence of VA and to investigate the factors associated with their occurrence in incident kidney transplant recipients. A total of 100 incident kidney transplant recipients were included in the study (39.7 ± 10.1 years, 55% male, 43.6 ± 10.1 days of transplantation, 66% living donors). All the patients underwent 24 h electrocardiogram, echocardiogram and multi‐slice computed tomography. Thirty percent of the patients had VA. Left ventricular hypertrophy was observed in 57% of the patients while heart failure was found in 5%. Coronary artery calcification (CAC) was observed in 26 patients, from which 31% had severe calcification. The group of patients with VA was predominantly male, had been on dialysis therapy for a longer time and had more coronary calcification. In the multiple logistic regression analysis, male gender and CAC score were independently associated with the presence of VA. In conclusion, kidney transplant recipients exhibited a high prevalence of VA and the factors associated with its occurrence were the male gender and the presence of CAC.
Fundamento: O Doppler tecidual é uma técnica que complementa a análise da função diastólica do ventrículo esquerdo. No entanto, alguns fatores podem influenciar suas medidas, entre estes a idade, cuja contribuição não está adequadamente esclarecida. Objetivo: Comparar o comportamento dos índices de função diastólica derivados do Doppler tecidual em indivíduos idosos hipertensos e não hipertensos. Métodos: Indivíduos com idade acima de 60 anos foram divididos em um grupo controle (GC), sem comorbidades cardiovasculares, e um grupo de hipertensos (HAS). Foram avaliadas as funções sistólica e diastólica (Doppler convencional e tecidual) do ventrículo esquerdo e obtidos os volumes do átrio esquerdo e massa ventricular. Resultados: Foram analisados 56 indivíduos (idade de 70,1 ± 6,6 anos), sendo 23 (41,1%) do GC e 33 (58,9%) do HAS. Os achados ecocardiográficos estruturais foram semelhantes entre os grupos, exceto para hipertrofia ventricular esquerda, mais frequente no HAS (34,4% versus 4,8%; p=0,017). A análise do Doppler tecidual não revelou diferenças entre os grupos (e' septal: 8,0 ± 1,5 versus 7,2 ± 1,9cm/s; p=0,08 e e' lateral: 9,8 ± 2,2 versus 8,7 ± 2,0cm/s; p=0,07, respectivamente para o GC e HAS). No HAS observou-se tempo de desaceleração da onda E (TD) mais prolongado (253 ± 62 versus 208 ± 36 ms no GC; p=0,003). Conclusão: Na análise da função diastólica em idosos, o Doppler tecidual não foi capaz de discriminar de forma acurada, indivíduos hipertensos, com maior potencial para a ocorrência de disfunção diastólica, de indivíduos não hipertensos. O TD revelou-se um parâmetro a ser valorizado nesta população. (Arq Bras Cardiol: Imagem cardiovasc. 2014;27(3):184-190) Palavras-chave: Doppler tecidual; idosos; hipertensão arterial; função diastólica.
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