The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end‐stage renal disease. Issue 11 (28th October 2021)

• Record Type: Journal Article
• Authors: Lassen, Mats Christian Højbjerg; Qasim, Atif; Webber, Allison; Gao, Ying; Biering‐Sørensen, Tor; Park, Meyeon
• Is Part Of: Echocardiography. Volume 38:Issue 11(2021)
• Page Start: 1879
• Page End: 1886
• Publication Date: 2021-10-28
• Subjects: diastolic strain rate -- E/e'sr -- end‐stage kidney disease -- kidney transplant; Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.15226
• Languages: English
• ISSNs: 0742-2822

Abstract

Abstract: Background: Diastolic dysfunction is an early marker of cardiac pathology in end‐stage kidney disease (ESKD) patients. The ratio of transmitral filling velocity (E) to early diastolic strain rate (E/e'sr) is a novel non‐invasive marker of early left ventricular (LV) filling pressure obtained using two‐dimensional speckle tracking echocardiography (2DSTE). Methods: In a prospective cohort of kidney transplant (KTX) recipients with echocardiograms performed pre‐transplant we obtained repeat echocardiograms at 6 months following transplant. All echocardiograms were analyzed using 2DSTE where E/e'sr and global longitudinal strain were obtained. Paired tests were used to assess changes to cardiac structure and function following KTX. Results: A total of 33 patients were included in the study (mean age was 46.6 ± 13.7 years and 42% were males). The primary causes of ESKD in the cohort were glomerular disease (33%), hypertension (30%), and polycystic kidney disease (12%). The median (IQR) time spent on dialysis was 5.4 years [2.9, 7.7 years]. A reverse remodeling of the LV was observed following KTX as LV mass decreased (189.2 ± 57.5 g vs 171.1 ± 56.8 g, P = 0.014). LV filling pressure decreased as assessed by E/e'sr (103.7 ± 51.1 cm vs 72.6 ± 35.5 cm, P = 0.009). E to early diastolic mitral annular tissue velocity (E/e') did not change following KTX (9.9 ± 4.5 vs 10.3 ± 4.1, P = 0.54). Additionally, both LV internal diastolic and systolic diameter decreased significantly. Conclusion: Reverse cardiac remodeling following KTX was observed as improvements in LV mass and LV dimensions. LV filling pressure improved as assessed by E/e'sr decreased following KTX, whereas E/e' did not change.