Cardiac response to early conversion from calcineurin inhibitor to everolimus in renal transplant recipients – a three‐yr serial echocardiographic substudy of the randomized controlled CENTRAL trial. (17th June 2015)

• Record Type: Journal Article
• Authors: Murbraech, Klaus; Massey, Richard; Undset, Liv H.; Midtvedt, Karsten; Holdaas, Hallvard; Aakhus, Svend
• Is Part Of: Clinical transplantation. Volume 29:Number 8(2015)
• Page Start: 678
• Page End: 684
• Publication Date: 2015-06-17
• Subjects: calcineurin inhibitor -- cardiovascular disease -- echocardiography -- everolimus -- kidney transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12565
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: In transplant recipients, calcineurin inhibitors (CNIs) are associated with adverse cardiac effects while mTOR inhibitors have been reported to be beneficial. We performed a randomized controlled trial (RCT) in de novo renal transplant recipients examining cardiac responses of everolimus vs. CNI. Methods: This was a substudy of the three‐yr CENTRAL study, an RCT on safety and efficacy of early (week 7 post‐engraftment) conversion from cyclosporine A (CsA) to everolimus vs. continued CsA. Thirty‐nine recipients [median age 64 yr, (range 31–81)] completed echocardiographic evaluations at baseline, one, and three yr. Results: After three yr, there was no difference between groups in left ventricle (LV) diastolic function, LV systolic function, LV morphology, and blood pressure response. We observed a relevant decrease in LV mass (CsA; 9.6%, p = 0.008, vs. everolimus; 7.0% reduction, p = 0.15), stabilized LV diastolic function, and a trend toward lower systolic blood pressure with 6 mmHg decrease in both arms (CsA, p = 0.08; everolimus, p = 0.14). Diastolic blood pressure was significantly reduced (8 mmHg decrease, p = 0.002) only in everolimus patients. Conclusions: After three‐yr follow‐up, no clinically relevant effect on cardiac function of an early conversion from CsA to an everolimus‐based immunosuppressive regimen was detected in de novo renal transplant recipients.