Abstract
To determine whether left ventricular (LV) global longitudinal strain (GLS) measured by feature-tracking (FT) cardiac magnetic resonance (CMR) improves after kidney transplantation (KT) and to analyze associations between LV GLS, reverse remodeling and myocardial tissue characteristics. This is a prospective single-center cohort study of kidney transplant recipients who underwent two CMR examinations in a 3T scanner, including cines, tagging, T1 and T2 mapping. The baseline exam was done up to 10 days after transplantation and the follow-up after 6 months. Age and sex-matched healthy controls were also studied for comparison. A total of 44 patients [mean age 50 ± 11 years-old, 27 (61.4%) male] completed the two CMR exams. LV GLS improved from − 13.4% ± 3.0 at baseline to − 15.2% ± 2.7 at follow-up (p < 0.001), but remained impaired when compared with controls (− 17.7% ± 1.5, p = 0.007). We observed significant correlation between improvement in LV GLS with reductions of left ventricular mass index (r = 0.356, p = 0.018). Improvement in LV GLS paralleled improvements in LV stroke volume index (r = − 0.429, p = 0.004), ejection fraction (r = − 0.408, p = 0.006), global circumferential strain (r = 0.420, p = 0.004) and global radial strain (r = − 0.530, p = 0.002). There were no significant correlations between LV GLS, native T1 or T2 measurements (p > 0.05). In this study, we demonstrated that LV GLS measured by FT-CMR improves 6 months after KT in association with reverse remodeling, but not native T1 or T2 measurements.
Highlights
Cardiovascular disease (CVD) remains the leading cause of death in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) [1]
Kidney transplantation (KT) was associated with reduced myocardial fibrosis [15], previous FT-Cardiac magnetic resonance (CMR) [16] and speckle-tracking echocardiography (STE) [17, 18] studies found different results about the effects of KT in left ventricular (LV) global longitudinal strain (GLS), which is the most reliable and studied strain parameter
In this study we sought to evaluate whether LV GLS measured by FT-CMR improves after KT and analyze associations between LV GLS, cardiac structure and myocardial tissue characteristics
Summary
Cardiovascular disease (CVD) remains the leading cause of death in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) [1]. This increased cardiovascular risk is mainly related to changes in cardiac structure and function named uremic cardiomyopathy (UC) [2, 3]. Previous CMR studies have shown subclinical features of myocardial disease characterized by reduced left ventricular (LV) GLS and increased myocardial fibrosis, as assessed by T1 mapping, in CKD [12] and ESRD [13, 14].
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