Journal of Cardiovascular Imaging

Korean Society of Echocardiography (한국심초음파학회)
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Changes in Cardiac Structure and Function After Kidney Transplantation: A New Perspective Based on Strain Imaging

  • Darae Kim (Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Minjeong Kim (Division of Cardiology, Myongji Hospital) ;
  • Jae Berm Park (Department of Surgery, Sungkyunkwan University School of Medicine) ;
  • Juhan Lee (Departement of Surgery, Yonsei University College of Medicine) ;
  • Kyu Ha Huh (Departement of Surgery, Yonsei University College of Medicine) ;
  • Geu-Ru Hong (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Jong-Won Ha (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Jin-Oh Choi (Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chi Young Shim (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine)
  • Received : 2022.10.28
  • Accepted : 2022.12.11
  • Published : 2023.04.27
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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

Acknowledgement

This study was supported by the Korean Society of Echocardiography.

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