Lower left atrial strain parameters LAScd and LASr were independently associated with increased major adverse cardiovascular events with HR 0.94 and 0.97 respectively in adult kidney transplant recipients over 5.3 years.
Observational (n=377)
No
Does abnormal pre-transplant left atrial strain predict major adverse cardiovascular events in kidney transplant recipients?
Pre-transplant left atrial strain parameters, specifically reservoir and conduit strain, are independent predictors of major adverse cardiovascular events following kidney transplantation.
Effect estimate: LAScd HR 0.94; LASr HR 0.97 (95% CI LAScd 0.89–0.98; LASr 0.94–0.995)
p-value: p=LAScd p=0.003; LASr p=0.02
Abstract Purpose Left atrial (LA) volume and strain parameters have been associated with cardiovascular outcomes in several cardiac pathologies, yet their role in predicting major adverse cardiovascular events (MACE) in kidney transplant (KT) recipients has not been explored. Methods We retrospectively reviewed the records of adult KT recipients from our institution (2015–2024). We utilized baseline echocardiograms routinely acquired during KT workup to measure LA volumetrics and strain. MACE was the study’s primary endpoint, defined as cardiovascular death, nonfatal myocardial infarction, stroke, major arrhythmias or heart failure hospitalization. Logistic regression, Kaplan-Meier and Cox proportional hazards regression were performed to evaluate the association between LA parameters and MACE. Results Of 518 patients who underwent kidney transplant, 377 were in sinus rhythm with an acceptable quality echocardiogram (male, 56.7%; mean age 53.7 ± 13.1 years). Over a median follow up duration of 5.3 ± 2.3 years from KT, 82 patients reached the study endpoint. Kaplan-Meier analysis showed significantly lower MACE-free survival in patients with abnormal LA strain. After adjusting for confounding variables in the Cox Proportional Hazards model, of all LA parameters, lower LAScd (HR 0.94, 95% CI 0.89–0.98, p = 0.003), and LASr (HR 0.97, 95% CI 0.94–0.995, p = 0.02) were independently associated with MACE. Conclusion In this retrospective single center study, LA strain parameters particularly LASr and LAScd were independently associated with MACE after KT. LA strain might have a role in risk stratification in this population.
DeLonais-Parker et al. (Mon,) conducted a observational in Adult kidney transplant recipients in sinus rhythm with adequate quality echocardiograms (n=377). Assessment of left atrial strain parameters (LASr and LAScd) vs. Normal vs abnormal LA strain values was evaluated on Major adverse cardiovascular events (MACE): cardiovascular death, non-fatal myocardial infarction, stroke, major arrhythmias, or heart failure hospitalization (LAScd HR 0.94; LASr HR 0.97, 95% CI LAScd 0.89–0.98; LASr 0.94–0.995, p=LAScd p=0.003; LASr p=0.02). Lower left atrial strain parameters LAScd and LASr were independently associated with increased major adverse cardiovascular events with HR 0.94 and 0.97 respectively in adult kidney transplant recipients over 5.3 years.