Key result
Solid-organ transplant recipients engaged in a moderate-intensity exercise program showed normal intracardiac vortex flow dynamics with no significant differences compared to healthy active controls.
Why the study?
Cardiovascular diseases remain the leading cause of morbidity and mortality in renal and liver transplant recipients, and vortex echocardiography parameters in physically active transplant recipients compared with healthy subjects had not been investigated.
Do vortex echo parameters differ between physically active solid-organ-transplanted subjects and healthy subjects?
Cross-Sectional (n=50)
No
Do vortex echo parameters differ between physically active solid-organ-transplanted subjects and healthy subjects?
HyperDoppler analysis of intracardiac vortex flow dynamics may help detect early diastolic changes in physically active solid-organ transplant recipients.
Preserved vortex dynamics in active transplant recipients warrant no immediate clinical change; leaves open utility for early diastolic monitoring in prospective studies.
Background: Cardiovascular diseases in the context of renal and liver transplants remain the leading cause of morbidity and mortality. Physical exercise at a moderate intensity is allowed to contrast the risk profile. Echocardiographic evaluation is essential to stratifying potential cardiotoxicity by the standard and, more recently, the deformation and dynamic study of the intracardiac vortex. This study aims to investigate the vortex echo parameters of solid-organ-transplanted subjects who are physically active compared to a control group of healthy subjects. Methods: A group of 33 transplanted subjects (16 kidneys and 17 livers) was studied via a transthoracic echocardiography exam, comprehending the myocardial deformation parameters of global longitudinal strain (GLS), twisting of the left ventricle (LV) chamber, and HyperDoppler image acquisition. Results: The subjects enrolled in this study were 50 in total: there were 33 transplanted and 17 healthy subjects. The transplanted subjects presented higher values of interventricular septum in diastole (IVSd p = 0.001), posterior wall diastolic (PWd p = 0.05), and left ventricle mass index (LVMI p = 0.029); ejection fraction (EF) was found to be higher in athletes (p < 0.001). Transplanted subjects presented mild diastolic dysfunction, emerging only from septal E values (p = 0.001). The 4DStrain (p = 0.018) and GLS2c (p = 0.017) were significantly better in the athletes. All of the geometrical and energetical vortex data were in the normal range and no significant differences were found. An interesting positive correlation was evident for the diastolic parameter, particularly the E/A ratio (p = 0.023) and E’ septal value (p = 0.049), along with the vorticity fluctuation. This behavior was present for all subjects, particularly those that were transplanted (p = 0.005). Conclusions: In the vortex investigation, especially in cases of normal EF, the positive correlation of some diastolic parameters with the flow dynamic patterns corroborates this hypothesis. The HyperDoppler analysis could be helpful to detecting potential damage earlier in the diastolic time before a systolic deficiency.
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Corsi et al. (2023) conducted a cross-sectional in Solid-organ transplantation (liver and renal) (n=50). Solid-organ transplantation vs. Healthy active subjects was evaluated on Vortex Area (p=0.14). Solid-organ transplant recipients engaged in a moderate-intensity exercise program showed normal intracardiac vortex flow dynamics with no significant differences compared to healthy active controls.
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