Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;26(6):1962-1970.
doi: 10.1007/s12350-018-1411-8. Epub 2018 Oct 22.

The effect of renal transplantation on left ventricular function, electrocardiography, and mechanical synchrony by gated myocardial perfusion imaging

William Crosland  1 , Himanshu Aggarwal  1 , Ayman Farag  1 , Shikha Mehta  2 , Roslyn B Mannon  2 , Jaekyeong Heo  1 , Ami E Iskandrian  1 , Fadi G Hage  3   4   5
Affiliations

The effect of renal transplantation on left ventricular function, electrocardiography, and mechanical synchrony by gated myocardial perfusion imaging

William Crosland et al. J Nucl Cardiol. 2019 Dec.

Abstract

Background: Depressed left ventricular ejection fraction (LVEF), LV mechanical dyssynchrony (LVMD), and prolonged QTc interval predict poor outcomes in end-stage renal disease (ESRD). Renal transplantation improves mortality in ESRD patients but the effects of transplantation on these indices remain undefined.

Methods: We identified patients with myocardial perfusion imaging (MPI) before and after renal transplantation. A control group consisted of ESRD patients who underwent 2 MPIs but did not receive a transplant. Changes in LVEF, LVMD indices [phase standard deviation (SD) and bandwidth (BW)] by MPI, and electrocardiogram (ECG) indices were determined.

Results: The study population consisted of 32 ESRD patients (53% male, 50 ± 11 years, 59% African American, 65% diabetic). The second MPI was performed 31 months (13-59 months) after renal transplantation. LVEF (72 ± 10% vs. 67 ± 10%, P < 0.001) but not SD (22 ± 15° vs. 22 ± 11°, P = 0.9) or BW (58 ± 35° vs. 57 ± 29°, P = 0.9) improved after transplantation. There were no changes in these indices in the control group. QTc (425 ± 30 ms vs. 447 ± 32 ms, P = <0.001) but not QRS (90 ± 21 ms vs. 90 ± 21 ms, P = 0.9) improved significantly after renal transplantation.

Conclusions: LVEF and QTc improved after renal transplantation but LVMD indices and QRS did not change, which suggests that LVMD and electrical dyssynchrony may be irreversible in ESRD.

Keywords: Myocardial biology; Physiology of LV/RV function; Physiology of myocardial/coronary perfusion.

PubMed Disclaimer

Comment in

References

    1. Hage FG, Venkataraman R, Zoghbi GJ, Perry GJ, DeMattos M, Iskandrian E. The scope of coronary heart disease in patients with chronic kidney disease. J Am Coll Cardiol. 2009;53:2129–40. - DOI
    1. Chiu DY, Sinha S, Kalra PA, Green D. Sudden cardiac death in haemodialysis patients: preventative options. Nephrology (Carlton). 2014;19:740–9. - DOI
    1. Hage FG, Smalheiser S, Zoghbi GJ, Perry GJ, Deierhoi M, Warnock D, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol. 2007;100:1020–5. - DOI
    1. Hage FG, de Mattos AM, Khamash H, Mehta S, Warnock D, Iskandrian AE. QT prolongation is an independent predictor of mortality in end-stage renal disease. Clin Cardiol. 2010;33:361–6. - DOI
    1. AlJaroudi W, Aggarwal H, Venkataraman R, Heo J, Iskandrian AE, Hage FG. Impact of left ventricular dyssynchrony by phase analysis on cardiovascular outcomes in patients with end-stage renal disease. J Nucl Cardiol. 2010;17:1058–64. - DOI

Publication types

LinkOut - more resources