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Is there a relation between duration of cyclosporine usage and right and left ventricular function in renal
Insights
Cyclosporine (CsA) use in renal transplant patients impairs biventricular diastolic function, despite normal systolic function. This highlights potential cardiac risks in long-term immunosuppression.
Area of Science:
- Cardiology
- Nephrology
- Immunosuppression
Background:
- Cyclosporine (CsA) is a vital immunosuppressant for renal transplant patients.
- CsA use is associated with myocardial fibrosis and hypertension.
- Cardiac function in CsA-treated patients requires thorough investigation.
Purpose of the Study:
- To evaluate the impact of CsA on cardiac function in renal transplant patients.
- To assess biventricular diastolic and systolic parameters in relation to CsA exposure duration.
Main Methods:
- Tissue Doppler imaging assessed diastolic (E/A, Te/a, Me/a) and systolic (Sm, St) parameters.
- Conventional Doppler measured E, A, deceleration time (DT), and isovolumetric relaxation time (IVRT).
- Left ventricular ejection fraction (EF) was also evaluated in 66 patients and 25 controls.
Main Results:
- Left ventricular EF remained normal across all patient groups.
- Isovolumetric relaxation time (IVRT) and deceleration time (DT) were elevated in renal transplant patients compared to controls.
- E/A ratios and other diastolic parameters showed decreased values in patients versus controls.
Conclusions:
- Renal transplant recipients on CsA exhibit impaired biventricular diastolic function.
- Systolic function, assessed by ejection fraction, remains preserved.
- Diastolic dysfunction is a significant finding in CsA-treated patients, irrespective of transplant duration.
Background:
Our aim was to investigate the effect of cyclosporine (CsA), which is commonly used in renal transplant patients and causes myocardial fibrosis and elevated arterial tension, on cardiac function.
Methods:
Sixty-six renal transplant patients (RTPs) and 25 healthy controls were included in the study. Renal transplantation patients were divided according to time of CsA exposure: group 1 (0 to 36 months); group 2 (36 to 72 months) and group 3 (> 72 months). Systolic peak velocity (Sm, mitral; St, tricuspid) and mitral early (e)/late (a) (Me/a) and tricuspid e/a (Te/a) waves of the right and the left ventricles were measured by pulse-wave (PW) Doppler used for tissue Doppler imaging of both ventricles as well as the ventricle free wall near to the lateral tricuspid and the posterior mitral leaflets. The measurements included conventional diastolic early (E) and late (A) waves and deceleration time (DT) of the E wave, isovolumetric relaxation time (IVRT) of both ventricles, as well as left ventricular systolic ejection fraction (EF).
Results:
There were no statistically significant differences between the groups with regard to demographic, clinical, and most biochemical characteristics. Left ventricular EF was normal in all groups; there were no statistically significant differences. IVRT and DT of left ventricle and right ventricle DT values were similar among RTPs. On the other hand, values were found to be increased in RTP groups compared with the control group. E/A ratio, Me/a Te/a of both ventricles were similar among RTPs. However, these values were found to be decreased in RTP groups compared with the control group.
Conclusions:
Although left ventricular systolic functions were normal in all groups, there were statistically significant impairments of biventricular diastolic function parameters among renal transplant recipients compared with the control group.
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