STUDY ON CHANGES IN LEFT VENTRICULAR STIFFNESS BY SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH END-STAGE CHRONIC KIDNEY DISEASE BEFORE AND AFTER KIDNEY TRANSPLANTATION
Main Article Content
Abstract
Objectives: To investigate the change in left ventricular stiffness by speckle tracking echocardiography (STE) in patients with end-stage chronic kidney disease (ESKD) before and after kidney transplantation. Methods: A prospective, cross-sectional descriptive study was conducted on 63 patients with ESKD who underwent kidney transplantation at Military Hospital 103 from October 2024 to April 2025. All patients were followed up 1 month after transplantation. Results: There was no significant difference in DWS before and after kidney transplantation. Left ventricular stiffness after kidney transplantation decreased significantly compared to before transplantation. Left ventricular stiffness after transplantation in the hemodialysis group increased significantly compared to the emptive treatment group when assessed by both tissue doppler (TDI) and STE. There was no difference in DWS after transplantation between the two treatment groups. Left ventricular stiffness after transplantation in the hemodialysis group > 12 months was significantly higher than that < 12 months when assessed by both TDI and STE. Conclusion: 1 month after kidney transplantation, left ventricular stiffness measured by 3 methods (DWS and E/e’/LVEDV and E/LASr/LVEDV) tended to improve, reflecting a reduction in myocardial stiffness. Factors such as pre-transplant treatment and duration of dialysis may also affect left ventricular stiffness.
Keywords
Left ventricular stiffness, Speckle-tracking echocardiography, End-stage chronic kidney disease, Kidney transplantation
Article Details
References
2. Wang C, Zhang N, Zhang L. Evaluation of Left ventricular stiffness with echocardiography. Echocardiography. 2024; 41(1):e15737.
3. Figueiredo Fernanda de Azevedo, Costa Admilson Lemos da, Figueiredo Flávio de Azevedo, et al. Left atrial strain: Clinical applications and prognostic implications. ABC Imagem Cardiovascular. 2024; 37(1).
4. Dang HNN, Luong TV, and Ho BA. Evaluation of the relationship between left atrial stiffness, left ventricular stiffness, and left atrioventricular coupling index in type 2 diabetes patients: A speckle tracking echocardiography study. Front. C. Frontiers. p. Med. 2024; 11:1372181.
5. Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure-abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004; 350(19):1953-1959.
6. Toma A, Kramer A, Berger S, et al. Improvement of cardiac function after successful kidney transplantation: A prospective echocardiographic study. Transplant Proc. 2012; 44(7):2024-2027.
7. Lassen MCH, Qasim A, Webber A. The effect of kidney transplantation on left ventricular remodeling and global diastolic strain rate in end-stage renal disease. Echocardiography. Nov 2021; 38(11):1879-1886.
8. Choi AW, Fong NC, Li VW. Left ventricular stiffness in paediatric patients with end-stage kidney disease. Pediatr Nephrol. Jun 2020; 35(6):1051-1060.
9. Obremska M, Kamińska D, Krawczyk M. Impact of different approaches to kidney transplant with and without chronic hemodialysis on cardiac function and morphology: A case-control study. J Clin Med. 2021; 10(17):3913.