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The effect of kidney transplant on cardiac function: an echocardiographic perspective
G Sahagún-Sánchez1, N Espinola-Zavaleta, M Lafragua-Contreras
1Department of Echocardiography, Instituto Nacional de Cardiología Ignacio Chávez, JuanBadiano No. 1, Colonia Sección XVI, Tlalpan, México, D.F., Mexico.
Insights
Kidney transplant (KT) significantly improves cardiac function in patients with chronic kidney failure (CKF). Echocardiography reveals reduced left ventricular hypertrophy and enhanced systolic and diastolic function post-transplant.
Area of Science:
- Nephrology
- Cardiology
- Medical Imaging
Background:
- Chronic kidney failure (CKF) is associated with significant cardiac abnormalities.
- These cardiac issues can include left ventricular hypertrophy and diastolic dysfunction.
- Kidney transplant (KT) is known to ameliorate some complications of CKF.
Purpose of the Study:
- To analyze cardiac alterations in patients with CKF.
- To evaluate the modifications in cardiac function after kidney transplantation.
- To assess the role of echocardiography in monitoring cardiac changes.
Main Methods:
- Thirteen patients with CKF underwent echocardiography, dobutamine stress echocardiography, and contrast perfusion studies before and 3 months after KT.
- Evaluated parameters included left ventricular hypertrophy, diastolic dysfunction, systolic and diastolic function, wall motion, and myocardial perfusion.
Main Results:
- Pre-transplant, nine patients showed left ventricular hypertrophy and six had diastolic dysfunction.
- Post-KT, left ventricular mass and thickness decreased, with only two patients retaining hypertrophy.
- Left ventricular systolic and diastolic function improved significantly, and myocardial perfusion remained normal.
Conclusions:
- Kidney transplant effectively diminishes cardiac hypertrophy and improves left ventricular systolic and diastolic function in CKF patients.
- Echocardiography is a valuable tool for detecting and monitoring cardiac abnormalities in kidney disease.
- The study found no indirect signs of coronary artery disease in the CKF patients evaluated.
Abstract:
Kidney transplant (KT) resolves many of the cardiac abnormalities associated with chronic kidney failure (CKF). This study analyzed cardiac alterations of kidney failure and their modification with transplant. Thirteen patients in CKF underwent conventional echocardiograms, dobutamine stress echocardiograms, and injection of contrast to examine perfusion before KT and 3 months after transplant. Nine patients had evidence of left ventricular hypertrophy and six had evidence of diastolic dysfunction. Wall thickness, left ventricular mass, and mass index diminished after KT; only two patients continued to manifest hypertrophy. Left ventricular systolic diameters and volumes diminished at 3 months, and diastolic diameters after 4 months. Left ventricular fractional shortening and ejection fraction increased 3 months after transplant. At the end of the study, only two patients continued to show diastolic dysfunction. Dobutamine echocardiograms showed no segmental wall-movement abnormalities. Myocardial perfusion was normal before and after transplant. The results suggest that KT diminishes hypertrophy and improves left ventricular systolic and diastolic function. Echocardiography provides valuable information for detection and follow-up of cardiac abnormalities in patients with kidney disease. Evaluation of segmental wall movement and myocardial perfusion aid in demonstrating that our studied patients with CKF had no indirect signs of coronary artery disease.