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Reversal of Left Ventricular Dysfunction after Renal Transplantation

Richard K. Burt, MD; Shalina Gupta-Burt, MD; Wadi N. Suki, MD; Camilo G. Barcenas, MD; James J. Ferguson, MD; and Charles T. Van Buren, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Wadi N. Suki, MD, 6550 Fannin, SM 1275, Houston, TX 77030.

Current Author Addresses: Dr. Burt: National Cancer Institute, Building 37, Room 3C25, Bethesda, MD 20892.

Dr. Gupta-Burt: National Cancer Institute, Building 37, Room 3B28, Bethesda, MD 20892.

Dr. Suki: 6550 Fannin, SM 1275, Houston, TX 77030.

Dr. Barcenas: St. Luke's Episcopal Hospital, 6720 Bertner, B592, Houston, TX 77030.

Dr. Ferguson: St. Luke's Episcopal Hospital, 6720 Bertner, Mail Code 1-191, Houston, TX 77030.

Dr. Van Buren: University of Texas Medical School-Houston, Room 6246, Main Building Medical School, 6431 Fannin, Houston, TX 77030.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(8):635-640. doi:10.7326/0003-4819-111-8-635
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We report the cases of four patients with end-stage renal disease and New York Heart Association class III or IV heart failure of nonischemic origin as documented by coronary angiography. Because of left ventricular dysfunction (left ventricular end-diastolic pressure, 23 to 30 mm Hg; ejection fraction, 20% to 35%), all four patients were initially considered poor surgical candidates for renal transplantation. These same four patients became asymptomatic, however, with markedly improved cardiac function (ejection fraction, 43% to 69%) detected as early as 6 and 14 days after renal engraftment. Therefore, there exists a subset of patients with end-stage renal disease in whom congestive heart failure should not be considered a contraindication to renal transplantation. We conclude that some dialysis-dependent patients who manifest symptomatic heart failure of nonischemic origin have a reversible cardiomyopathy and should not be denied renal transplantation.





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