Left ventricular structure and function in long-term kidney transplantation: the influence of glucose metabolism and...

Area of Science:

• Nephrology
• Cardiology
• Metabolic Research

Background:

• Cardiovascular disease is a major complication in renal transplant recipients, impacting morbidity, mortality, and graft survival.
• Cardiac abnormalities, including impaired structure and function, are prevalent in these patients.
• The roles of glucose metabolism and oxidative stress in these cardiac issues require further elucidation.

Purpose of the Study:

• To investigate factors contributing to cardiac abnormalities in long-term, non-diabetic renal transplant recipients.
• To specifically examine the influence of glucose metabolism and oxidative stress on cardiac function.

Main Methods:

• Echocardiography was performed on 54 non-diabetic renal transplant recipients without valvulopathy.
• Biochemical analyses included lipid profile, hemoglobin A1c (HbA1c), and oxidative stress markers (malondialdehyde, superoxide dismutase, total glutathione, isoprostanes).
• Left ventricular mass index (LVMI), ejection fraction, and E/A ratio (index of diastolic dysfunction) were calculated.

Main Results:

• Diastolic dysfunction (LVDD) was observed in 59.25% of patients.
• The E/A ratio showed a significant negative association with HbA1c and age, and a positive association with total glutathione.
• Multiple regression analysis identified HbA1c as a significant predictor of LVDD, independent of mean blood pressure (MBP) or LVMI.

Conclusions:

• Subclinical glucose metabolism impairment, as indicated by HbA1c, may causally influence diastolic dysfunction in renal transplant recipients.
• Impaired oxidative stress status appears to mediate the relationship between glucose metabolism and diastolic dysfunction.
• These findings suggest that managing glucose metabolism is crucial for preventing cardiac dysfunction post-transplantation, irrespective of blood pressure or LVH severity.