BACKGROUND Kidney transplant patients suffer from vascular abnormalities and high cardiovascular event rates, despite initial improvements post-transplantation. The nature of the progression of vascular abnormalities in the longer term is unknown. This pilot study investigated changes in vascular abnormalities over time in stable kidney transplant patients long after transplantation. METHODS Brachial artery flow-mediated dilation (FMD), nitroglycerin-mediated dilation, carotid-femoral pulse wave velocity (cf-PWV), ankle-brachial pressure index, and common carotid artery intima-media thickness (CCA-IMT) were assessed in 18 kidney transplant patients and 17 controls at baseline and 3-6 months after. RESULTS There was no difference in age (51 ± 13 vs. 46 ± 11; P = 0.19), body mass index (26 ± 5 vs. 25 ± 3; P = 0.49), serum cholesterol (4.54 ± 0.96 vs. 5.14 ± 1.13; P = 0.10), systolic blood pressure (BP) (132 ± 12 vs. 126 ± 12; P = 0.13), diastolic BP (82 ± 9 vs. 77 ± 8; P = 0.10), or diabetes status (3 vs. 0; P = 0.08) between transplant patients and controls. No difference existed in vascular markers between patients and controls at baseline. In transplant patients, FMD decreased (- 1.52 ± 2.74; P = 0.03), cf-PWV increased (0.62 ± 1.06; P = 0.03), and CCA-IMT increased (0.35 ± 0.53; P = 0.02). No changes were observed in controls. CONCLUSION Markers of vascular structure and function worsen in the post-transplant period on long-term follow-up, which may explain the continued high cardiovascular event rates in this population.

中文翻译：

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稳定肾移植患者的内皮功能障碍，动脉粥样硬化和动脉僵硬的进展：一项初步研究。

背景技术尽管移植后已有初步改善，但肾脏移植患者仍患有血管异常和高心血管事件发生率。从长远来看，血管异常进展的性质尚不清楚。这项初步研究调查了长期移植后稳定的肾移植患者的血管异常随时间的变化。方法评估肱动脉血流介导的扩张（FMD），硝酸甘油介导的扩张，颈股动脉脉搏波速度（cf-PWV），踝臂压力指数和颈总动脉内膜中层厚度（CCA-IMT）。在基线时和术后3-6个月，有18例肾脏移植患者和17例对照。结果年龄（51±13 vs. 46±11; P = 0.19），体重指数（26±5 vs. 25±3; P = 0.49），血清胆固醇（4.54±0）没有差异。96比5.14±1.13；P = 0.10），收缩压（BP）（132±12 vs. 126±12; P = 0.13），舒张压（82±9 vs. 77±8; P = 0.10）或糖尿病状态（3 vs. 0； P = 0.08）在移植患者和对照组之间。基线时患者与对照组之间的血管标记物无差异。移植患者的FMD降低（-1.52±2.74; P = 0.03），cf-PWV增加（0.62±1.06; P = 0.03），CCA-IMT增加（0.35±0.53; P = 0.02）。在对照中未观察到变化。结论长期随访发现，移植后血管结构和功能的指标恶化，这可能解释了该人群心血管事件的持续高发生率。P = 0.08）。基线时患者与对照组之间的血管标记物无差异。移植患者的FMD降低（-1.52±2.74; P = 0.03），cf-PWV增加（0.62±1.06; P = 0.03），CCA-IMT增加（0.35±0.53; P = 0.02）。在对照中未观察到变化。结论长期随访发现，移植后血管结构和功能的指标恶化，这可能解释了该人群心血管事件的持续高发生率。P = 0.08）。基线时患者与对照组之间的血管标记物无差异。移植患者的FMD下降（-1.52±2.74; P = 0.03），cf-PWV增加（0.62±1.06; P = 0.03），CCA-IMT增加（0.35±0.53; P = 0.02）。在对照中未观察到变化。结论长期随访发现，移植后血管结构和功能的指标恶化，这可能解释了该人群心血管事件的持续高发生率。