التفاصيل البيبلوغرافية
| العنوان: |
Islet transplantation is associated with an improvement of cardiovascular function in type 1 diabetic kidney transplant patients. |
| المؤلفون: |
Fiorina, Paolo, Gremizzi, Chiara, Maffi, Paola, Caldara, Rossana, Tavano, Davide, Monti, Lucilla, Socci, Carlo, Folli, Franco, Fazio, Ferruccio, Astorri, Ettore, Del Maschio, Alessandro, Secchi, Antonio |
| المصدر: |
Diabetes Care; Jun2005, Vol. 28 Issue 6, p1358-1365, 8p, 3 Charts, 2 Graphs |
| مصطلحات موضوعية: |
CARDIOVASCULAR diseases, DIABETES, PEOPLE with diabetes, CHRONIC kidney failure, ISLANDS of Langerhans transplantation, PEPTIDES, TRANSPLANTATION of organs, tissues, etc. |
| مستخلص: |
OBJECTIVE -- Cardiovascular mortality and morbidity are major problems in type 1 diabetic patients with end-stage renal disease (ESRD). The aim of this study was to determine whether islet transplantation can improve cardiovascular function in these patients. RESEARCH DESIGN AND METHODS -- We assessed various markers of cardiac function at baseline and 3 years later in a population of 42 type 1 diabetic patients with ESRD who received a kidney transplant. Seventeen patients then received an islet transplant that had persistent function as defined by long-term C-peptide secretion (kidney-islet group). Twenty-five patients did not receive a functioning islet transplant (kidney-only group). RESULTS -- GHb levels were similar in the two groups, whereas the exogenous insulin requirement was lower in the kidney-islet group with persistent C-peptide secretion. Overall, cardiovascular parameters improved in the kidney-islet group, but not in the kidney-only group, with an improvement of ejection fraction (from 68.2 ± 3.5% at baseline to 74.9 ± 2.1% at 3 years posttransplantation, P < 0.05) and peak filling rate in end-diastolic volume (EDV) per second (from 3.87 ± 0.25 to 4.20 ± 0.37 EDV/s, P < 0.05). Time to peak filling rate remained stable in the kidney-islet group but worsened in the kidney-only group (P < 0.05). The kidney-islet group also showed a reduction of both QT dispersion (53.5 ± 4.9 to 44.6 ± 2.9 ms, P < 0.05) and corrected QT (QTc) dispersion (67.3 ± 8.3 to 57.2 ± 4.6 ms, P < 0.05) with higher erythrocytes Na+-K+-ATPase activity. In the kidney-islet group only, both atrial natriuretic peptide and brain natriuretic peptide levels decreased during the follow-up, with a stabilization of intima-media thickness. CONCLUSIONS -- Our study showed that type 1 diabetic ESRD patients receiving a kidney transplant and a functioning islet transplant showed an improvement of cardiovascular function for up to 3 years of follow-up compared with the kidney-only group, who experienced an early failure of the islet graft or did not receive an islet graft. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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