Abstract
BackgroundAdvanced chronic kidney disease often results in adverse cardiovascular outcomes and is the leading cause of mortality in patients with end stage renal diseases (ESRD). There is much information about the effect of chronic kidney diseases (CKD) on the left ventricle (LV) chamber, but the right ventricle (RV) as a neglected chamber had not been evaluated precisely, in spite of its importance.ObjectivesThe aim of this study was to evaluate the impact of successful kidney transplants on the RV systolic and diastolic function using the advanced method of 2D speckle tracking echocardiography and comparison with the conventional methods.MethodThe study included 48 patients with CKD who were eligible for kidney transplantation and underwent successful kidney transplantations. Right ventricular indices were evaluated, while RV function was focused by conventional methods and 2D speckle tracking echocardiography before the successful kidney transplant and 1 week, 1 month, and 3 months after the successful kidney transplant.ResultsThe results of the study showed that RV global longitudinal strain and RV free wall longitudinal strain improved over the time (P = 0.024, P < 0.001 respectively). It also represented that kidney transplantation did not have significant effect on the RV mid cavity diameter, tissue velocity, Myocardial performance index, RV longitudinal diameter, and Tricuspid annular plane systolic excursion indices, but for other indices this effect was significant. On the differences between the mean slope of regression line of the GLS variable in hypertensive subjects (1.0 ± 0.2) and non-hypertensive subjects (0.36 ± 0.32), an independent t-test showed that between the two groups in terms of the improvement of RVGLS, there was a significant statistical difference (P = 0.0067).ConclusionMost of the ESRD patients had subtle RV dysfunction which could be better detected by recent echocardiography methods than conventional methods. Moreover, kidney transplantation led to considerable improvements in RV function in this population.
Highlights
Accounting for 40% of deaths in international registries, cardiac disease is the main cause of death in dialysis patients [1]
The results of the study showed that right ventricle (RV) global longitudinal strain and RV free wall longitudinal strain improved over the time (P = 0.024, P < 0.001 respectively)
Most of the end stage renal diseases (ESRD) patients had subtle RV dysfunction which could be better detected by recent echocardiography methods than conventional methods
Summary
Accounting for 40% of deaths in international registries, cardiac disease is the main cause of death in dialysis patients [1]. It is due to progressive cardiorenal compromise which causes adverse cardiovascular outcomes by accelerated atherosclerosis and subsequent coronary artery disease, and by other mechanisms such as hemodynamic overload from volume and pressure, anemia, arteriovenous shunts and arterial remodeling as well as biochemical mediators and uremic toxics [2]. Kidney transplant is considered as the standard treatment for patients with ESRD [4]. Echocardiography is a tool for the noninvasive assessment of hemodynamic parameters and the evaluation of cardiac chamber size and function of the heart. Speckle tracking echocardiography (STE) has been considered as an advanced method that can evaluate subtle myocardium diseases. Advanced chronic kidney disease often results in adverse cardiovascular outcomes and is the leading cause of mortality in patients with end stage renal diseases (ESRD). There is much information about the effect of chronic kidney diseases (CKD) on the left ventricle (LV) chamber, but the right ventricle (RV) as a neglected chamber had not been evaluated precisely, in spite of its importance
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