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Updated: Oct 3, 2025
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Subclinical cardiac dysfunction in pediatric kidney transplant recipients identified by speckle-tracking
Adrienn Bárczi1, Bálint Károly Lakatos2, Mónika Szilágyi2
11st Department of Pediatrics, Semmelweis University, Bókay János Str. 53-54, Budapest, 1083, Hungary.
Insights
Pediatric kidney transplant recipients show cardiac changes, including hypertrophy and subclinical dysfunction, detectable by speckle-tracking echocardiography (STE). Blood pressure control and kidney function significantly impact cardiac performance in these children.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Cardiovascular Imaging
Background:
- Kidney transplantation (KTx) improves outcomes for children with kidney failure but leaves them susceptible to cardiovascular damage.
- Multiple cardiovascular risk factors persist post-transplantation, necessitating monitoring of cardiac health.
Purpose of the Study:
- To assess myocardial structure and function in pediatric KTx patients using conventional and speckle-tracking echocardiography (STE).
- To correlate cardiac changes with established cardiovascular risk factors in this population.
Main Methods:
- Evaluated 42 KTx recipients and 39 healthy controls using conventional echocardiography and 2D STE.
- Measured left and right ventricular (LV, RV) global longitudinal strain (GLS) and LV circumferential strain (GCS).
- Assessed arterial stiffness (PWV), blood pressure (ABPM), and estimated glomerular filtration rate (eGFR).
Main Results:
- KTx patients exhibited increased blood pressure, arterial stiffness, and elevated LV mass index (LVMi) with preserved ejection fraction.
- LVGLS was significantly reduced in KTx patients, while LVGCS and RVGLS were increased.
- Uncontrolled hypertension correlated with lower LVGLS; 24-h SBP and relative wall thickness (RWT) determined LVMi, while antihypertensive therapy, eGFR, and HOMA-IR influenced LVGLS.
Conclusions:
- Pediatric KTx recipients display distinct cardiac morphological and functional changes, including LV hypertrophy and subclinical myocardial dysfunction.
- Effective control of hypertension and optimal kidney graft function are crucial for maintaining LV performance.
- STE is a valuable tool for detecting early myocardial dysfunction in pediatric KTx patients.
Background:
Kidney transplantation (KTx) improves prognosis in children with kidney failure; still, these patients are prone to cardiovascular damage due to multiple risk factors. Our aim was to assess myocardial structure and function in pediatric KTx by conventional and speckle-tracking echocardiography (STE) in association with established cardiovascular risk factors.
Methods:
Forty-two KTx and 39 healthy age- and gender-matched children were evaluated. KTx recipients were further categorized according to the control of hypertension assessed by 24-h ambulatory blood pressure monitoring (ABPM). Subjects underwent pulse wave velocity (PWV) measurement, conventional echocardiography, and 2-dimensional STE. Left and right ventricular (LV, RV) global longitudinal strain (GLS), and LV circumferential strain (GCS) were measured. Glomerular filtration rate (eGFR) was calculated according to the Schwartz formula.
Results:
KTx patients had increased blood pressure and arterial stiffness. LV ejection fraction (EF) was preserved along with elevated LV mass index (LVMi) while LVGLS was significantly lower, whereas LVGCS and RVGLS were increased in KTx. Uncontrolled hypertensives had lower LVGLS compared to those with controlled hypertension. Using multiple forward stepwise regression analysis, 24-h SBP and relative wall thickness (RWT) were independent determinants of LVMi, whereas antihypertensive therapy, eGFR, and HOMA-IR were independent determinants of LVGLS.
Conclusions:
Cardiac morphology and function show distinct changes after KTx. Along with comparable ventricular volumes, LV hypertrophy and subclinical myocardial dysfunction are present. Control of hypertension and kidney graft function are major factors of LV performance. STE may be useful to reveal early myocardial dysfunction in pediatric KTx. A higher resolution version of the Graphical abstract is available as Supplementary information.
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01:28Kidney Transplant I: Introduction
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