Effect of Renal Transplantation on Left Ventricular Myocardial Deformation in Patients With End-Stage Renal Disease.

Background: End-stage renal disease (ESRD) is associated with significant left ventricular (LV) remodeling. However, the impact of renal transplantation on LV remodeling has not been adequately elucidated.

Methods: A comprehensive echocardiography was performed before and after (median time interval 239 days, interquartile range 149-328 days) renal transplantation in 42 patients (mean age 39.1 ± 11.0 years, 79% men). Forty-five apparently healthy age- and gender-matched controls were also included.

Results: The patients with ESRD had significantly increased LV mass index, left atrial volume index (LAVI), and the ratio of early diastolic mitral inflow velocity to mitral annular velocity (E/e'), whereas LV global longitudinal strain (GLS), circumferential strain, apical rotation, and twist were reduced. LV ejection fraction (LVEF) was also lower, but the LV global radial strain (GRS) was not different between the two groups. Most of these abnormalities showed improvement after renal transplantation. Nearly one-third of all patients had at least a 10% improvement in LVEF, and roughly half had a 10% or more improvement in the mitral E/e' ratio and the LV global longitudinal and circumferential strain.

Conclusion: This study shows that renal transplantation results in a significant regression of LV hypertrophy and an improvement in LV myocardial deformation translating into an improvement in the LV systolic and diastolic function. Further larger and long-term studies are needed to identify the predictors and the clinical significance of these changes.