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

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

.