Changes in Cardiac Structure and Function After Kidney Transplantation: A New Perspective Based on Strain Imaging
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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|.
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|.
참고문헌 (29)
- Tonelli M, "Chronic kidney disease and mortality risk : a systematic review", J Am Soc Nephrol, 17, pp.2034~2047 (2006)
- Go AS, "Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization", N Engl J Med, 351, pp.1296~1305 (2004)
- Unger ED, "Association of chronic kidney disease with abnormal cardiac mechanics and adverse outcomes in patients with heart failure and preserved ejection fraction", Eur J Heart Fail, 18, pp.103~112 (2016)
- Löfman I, "Associations with and prognostic impact of chronic kidney disease in heart failure with preserved, mid-range, and reduced ejection fraction", Eur J Heart Fail, 19, pp.1606~1614 (2017)
- Marx N, "Cardiovascular disease in patients with chronic kidney disease", Herz, 46, pp.205~ (2021)
- Port FK, "Comparison of survival probabilities for dialysis patients vs cadaveric renal transplant recipients", JAMA, 270, pp.1339~1343 (1993)
- Ojo AO, "Comparative mortality risks of chronic dialysis and cadaveric transplantation in black end-stage renal disease patients", Am J Kidney Dis, 24, pp.59~64 (1994)
- Tonelli M, "Systematic review : kidney transplantation compared with dialysis in clinically relevant outcomes", Am J Transplant, 11, pp.2093~2109 (2011)
- Hawwa N, "Reverse remodeling and prognosis following kidney transplantation in contemporary patients with cardiac dysfunction", J Am Coll Cardiol, 66, pp.1779~1787 (2015)
- Dumesnil JG, "Effect of the geometry of the left ventricle on the calculation of ejection fraction", Circulation, 65, pp.91~98 (1982)
- Krayenbuehl HP, "Left ventricular systolic function in aortic stenosis", Eur Heart J, 9(Suppl E), pp.19~23 (1988)
- Ross J Jr, "Afterload mismatch and preload reserve : a conceptual framework for the analysis of ventricular function", Prog Cardiovasc Dis, 18, pp.255~264 (1976)
- Gorcsan J 3rd, "Echocardiographic assessment of myocardial strain", J Am Coll Cardiol, 58, pp.1401~1413 (2011)
- Farsalinos KE, "Head-to-head comparison of global longitudinal strain measurements among nine different vendors : the EACVI", ASE inter-vendor comparison study, 2015, pp.28, 1171~1181
- Mirea O, "Variability and reproducibility of segmental longitudinal strain measurement : a report from the EACVI-ASE strain standardization task force", JACC Cardiovasc Imaging, 11, pp.15~24 (2018)
- Lang RM, "Recommendations for chamber quantification : a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology", J Am Soc Echocardiogr, 18, pp.1440~1463 (2005)
- Kraigher-Krainer E, "Impaired systolic function by strain imaging in heart failure with preserved ejection fraction", J Am Coll Cardiol, 63, pp.447~456 (2014)
- Lentine KL, "De novo congestive heart failure after kidney transplantation : a common condition with poor prognostic implications", Am J Kidney Dis, 46, pp.720~733 (2005)
- Wali RK, "Effect of kidney transplantation on left ventricular systolic dysfunction and congestive heart failure in patients with end-stage renal disease", J Am Coll Cardiol, 45, pp.1051~1060 (2005)
- Rasić S, "Left ventricular hypertrophy and risk factors for its development in uraemic patients", Bosn J Basic Med Sci, 4, pp.34~40 (2004)
- Kramann R, "Speckle tracking echocardiography detects uremic cardiomyopathy early and predicts cardiovascular mortality in ESRD", J Am Soc Nephrol, 25, pp.2351~2365 (2014)
- López B, "Myocardial fibrosis in chronic kidney disease : potential benefits of torasemide", Kidney Int Suppl, 74, pp.S19~S23 (2008)
- Zoccali C, "Chronic fluid overload and mortality in ESRD", J Am Soc Nephrol, 28, pp.2491~2497 (2017)
- Alhaj E, "Uremic cardiomyopathy : an underdiagnosed disease", Congest Heart Fail, 19, pp.E40~E45 (2013)
- Vlahakos DV, "Relationship between left ventricular hypertrophy and plasma renin activity in chronic hemodialysis patients", J Am Soc Nephrol, 8, pp.1764~1770 (1997)
- Sato A, "Involvement of aldosterone in left ventricular hypertrophy of patients with end-stage renal failure treated with hemodialysis", Am J Hypertens, 12, pp.867~873 (1999)
- Xue C, "Fibroblast growth factor 23 predicts all-cause mortality in a dose-response fashion in pre-dialysis patients with chronic kidney disease", Am J Nephrol, 45, pp.149~159 (2017)
- Mirza MA, "Serum intact FGF23 associate with left ventricular mass, hypertrophy and geometry in an elderly population", Atherosclerosis, 207, pp.546~551 (2009)
- Rakhit DJ, "Prognostic role of subclinical left ventricular abnormalities and impact of transplantation in chronic kidney disease", Am Heart J, 153, pp.656~664 (2007)