Left ventricular hypertrophy, treadmill tests, and 24-hour blood pressure in pediatric transplant patients.

Abstract

Hypertension and left ventricular hypertrophy (LVH) are possible complications in pediatric patients after renal transplantation. We performed left ventricular echocardiography, 24-hour ambulatory blood pressure monitoring (24-hr ABPM), and treadmill tests in 28 pediatric renal transplant patients (mean age 16.1 +/- 3.7; time since transplantation 36 +/- 23 months). Left ventricular mass (LVM) was indexed for height 2.7. LVH was found in 82% of the patients. Seven of these patients were normotensive by 24-hour ABPM, but five patients showed a hypertensive systolic BP response during the treadmill test. LVM/height 2.7 correlated significantly with the mean 24-hour systolic BP (P = 0.002) and with the maximal exercise systolic BP (P = 0.002). LVH is frequent in pediatric renal transplant patients. More information is needed with respect to the risk for LVH, including data from 24-hour ABPM and treadmill testing.