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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
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Changes in left ventricular structure and function associated with renal transplantation: a systematic review and
Luke C Pickup1, Jonathan P Law1, Ashwin Radhakrishnan1
1Birmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
ESC Heart Failure
|May 14, 2021
Summary
Renal transplantation does not reverse cardiac changes in uraemic cardiomyopathy. Limited and methodologically weak evidence suggests no significant differences in key cardiac measures post-transplant. Further research is needed.
Area of Science:
- Nephrology
- Cardiology
- Translational Medicine
Background:
- Uraemic cardiomyopathy is a significant complication in patients with chronic kidney disease.
- Cardiac structural and functional changes are common in uraemia.
- The potential for reversal of these cardiac changes following renal transplantation remains unclear.
Purpose of the Study:
- To systematically review and meta-analyze existing evidence on the reversibility of uraemic cardiomyopathy after successful renal transplantation.
- To assess the impact of renal transplantation on cardiac structure and function in patients with uraemic cardiomyopathy.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (MEDLINE, Embase, OpenGrey, Cochrane Library) from 1950 to March 2020.
- Studies utilizing imaging modalities (echocardiography, cardiac MRI) before and after renal transplantation were included.
- Meta-analysis was employed to synthesize data, with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system used for evidence quality assessment.
Main Results:
- Twenty-six studies met the inclusion criteria; 23 used echocardiography and 3 used cardiac MRI.
- Methodological quality of the included studies was generally poor.
- Meta-analysis revealed no significant differences in left ventricular mass index (SMD -0.07, 95% CI -0.41 to 0.26), left ventricular ejection fraction (MD 0.39%, 95% CI -4.09% to 4.87%), or left ventricular end-diastolic volume (SMD -0.24, 95% CI -0.94 to 0.45) post-transplantation.
- Analysis of diastolic dysfunction changes was precluded by inconsistent reporting.
Conclusions:
- Current evidence does not support the reversibility of uraemic cardiomyopathy following renal transplantation.
- The findings are limited by significant methodological weaknesses in the available studies.
- Further high-quality research is warranted to definitively assess the impact of renal transplantation on uraemic cardiomyopathy.
Keywords:
CardiomyopathyEchocardiographyHeart failureKidney transplantationMagnetic resonance imagingMeta-analysisMore Related Videos
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