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. 2023 Apr;31(2):98-104.
doi: 10.4250/jcvi.2022.0125.

Changes in Cardiac Structure and Function After Kidney Transplantation: A New Perspective Based on Strain Imaging

Darae Kim  1 , Minjeong Kim  2 , Jae Berm Park  3 , Juhan Lee  4 , Kyu Ha Huh  4 , Geu-Ru Hong  5 , Jong-Won Ha  5 , Jin-Oh Choi  6 , Chi Young Shim  7
Affiliations

Changes in Cardiac Structure and Function After Kidney Transplantation: A New Perspective Based on Strain Imaging

Darae Kim et al. J Cardiovasc Imaging. 2023 Apr.

Abstract

Background: We aimed to investigate left ventricular (LV) global longitudinal strain (GLS) in end-stage renal disease patients and its change after kidney transplantation (KT).

Methods: We retrospectively reviewed patients who underwent KT between 2007 and 2018 at two tertiary centers. We analyzed 488 patients (median age, 53 years; 58% male) who had obtained echocardiography both before and within 3 years after KT. Conventional echocardiography and LV GLS assessed by two-dimensional speckle-tracking echocardiography were comprehensively analyzed. Patients were classified into three groups according to the absolute value of pre-KT LV GLS (|LV GLS|). We compared longitudinal changes of cardiac structure and function according to pre-KT |LV GLS|.

Results: Correlation between pre-KT LV EF and |LV GLS| were statistically significant, but the constant was not high (r = 0.292, p < 0.001). |LV GLS| was widely distributed at corresponding LV EF, especially when the LV EF was > 50%. Patients with severely impaired pre-KT |LV GLS| had significantly larger LV dimension, LV mass index, left atrial volume index, and E/e' and lower LV EF, compared to mildly and moderately reduced pre-KT |LV GLS|. After KT, the LV EF, LV mass index, and |LV GLS| were significantly improved in three groups. Patients with severely impaired pre-KT |LV GLS| showed the most prominent improvement of LV EF and |LV GLS| after KT, compared to other groups.

Conclusions: Improvements in LV structure and function after KT were observed in patients throughout the full spectrum of pre-KT |LV GLS|.

Keywords: Global longitudinal strain; Kidney transplantation; Left ventricle.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1. Correlation between pre-kidney transplantation |LV GLS| and LVEF.
EF: ejection fraction, GLS: global longitudinal strain, LV: left ventricle. T1 = lowest tertile, T2 = middle tertile, T3 = highest tertile.
Figure 2
Figure 2. Change of LV function, LV mass index and LA volume index after KT according to pre-KT |LV GLS| tertiles.
EF: ejection fraction, GLS: global longitudinal strain, LA: left atrium, LV: left ventricle, MI: mass index, VI: volume index. T1 = lowest tertile, T2 = middle tertile, T3 = highest tertile.
See this image and copyright information in PMC

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