Over-time mitral regurgitation changes following cardiac resynchronization therapy.

PURPOSE: Mitral regurgitation (MR) is a leading cause of mortality in patients with heart failure (HF). Cardiac resynchronization therapy (CRT) has been shown to improve MR in these patients, but maintenance of MR improvement after CRT implantation has not yet been evaluated. We aimed to evaluate the post-CRT improvement pattern of MR in a 6-month follow-up period. MATERIALS AND METHODS: 65 consecutive patients scheduled for CRT implantation with inclusion criteria of moderate to severe heart failure, left ventricular ejection fraction (LVEF) 120 ms with left bundle branch block configuration were invited to participate. 60 patients with MR were registered. Clinical, electrocardiographic and echocardiographic evaluations were recorded before CRT implantation and 3 and 6 months after. RESULTS: We found significant improvement in MR score, NYHA class, QRS duration, LVEF and left ventricular end diastolic diameter (LVEDD) at the 3-month follow-up (p<0.001). These parameters also improved significantly (p<0.0001) between the 3 and 6-month follow-ups except for the MR score, which did not show any significant improvement. CONCLUSION: MR improvement was sustained after CRT implantation between the 3 and 6-month follow-ups.

Hyperlipidemia after renal transplantation and its relation to graft and patient survival.

INTRODUCTION: Hyperlipidemia is a multifactorial event that frequently develops following renal transplantation and may worsen the patient's prognosis. The aim of this study was to evaluate the incidence and concomitant factors for hyperlipidemia. METHODS: We studied 687 renal transplant recipients from 1988 to 2004 using a cross-sectional design to determine the frequency of hypercholestrolemia and hypertriglyceridemia before and 1 month to 1 year after renal transplantation, to evaluate its relation to patient and graft prognosis in two medical centers in Iran. Cyclosporine was the constant part of immunosuppressive treatment in all study subjects. RESULTS: One and 5-year graft survival times were 94.23% and 81.34%, respectively. The prevalence of hypercholestrolemia after transplantation was 59.9%. Mean (+/- 2 SE) serum cholesterol levels before and after transplantation were 161.15 +/- 3.81 and 213.83 +/- 4.53 mg/dL respectively (P=.000). Triglycerides levels, were 159.99 +/- 13.08 and 196.28 +/- 19.6 mg/dL respectively. There was no significant correlation between cyclosporine dose, graft and patient survivals, and severity of hyperlipidemia (determined by cholesterol and triglyceride levels). CONCLUSIONS: Lipid metabolism abnormalities observed in this study were similar to other reports. There was no correlation with patient or graft survival. In addition, there may routes for development of hyperlipidemia other than adverse complications of immunosuppressive drugs.