Transient decline and early recovery of noninvasive myocardial work after kidney transplantation: a prospective study.

Background: Patients with chronic kidney disease (CKD) are at a high risk of cardiovascular disease. This study aims to observe the short-term changes of left ventricular (LV) myocardial work in stage 5 CKD patients with successful kidney transplantation (KT).

Methods: 45 stage 5 CKD patients who are candidates for KT were enrolled. Changes in clinical variables, laboratory data, routine transthoracic echocardiography, and noninvasive myocardial work (NIMW) were analyzed at pre-KT, 10 days, and 3 months post-KT. NIMW parameters include global myocardial work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).

Results: 1) Renal function indicators, including blood urea nitrogen, serum creatinine, and estimated glomerular filtration rate improved significantly at 10 days post-KT. At 3 months post-KT, there appears to be a continuing recovery trend; 2) GWE, GWI, and GCW were significantly increased at 3 months post-KT, but GCW and GWI with an early decrease at 10 days post-KT; 3) At the 10 days post-KT, the changes in systolic blood pressure and hemoglobin were positively correlated with the changes in GWI. Meanwhile, the change in systolic blood pressure was also positively correlated with the change in GCW. The change in diastolic blood pressure was positively correlated with the change in GWW.

Conclusion: LV systolic function doesn't improve in parallel with renal function after a successful KT. Steadily controlling blood pressure and correcting anemia is associated with improving myocardial work after KT, especially in the early post-transplant period.