Pediatric kidney transplant recipients exhibited subclinical myocardial dysfunction with significantly impaired left ventricular global longitudinal strain (-20.64% vs -21.78%) compared to healthy controls.
Cross-Sectional (n=81)
No
Does kidney transplantation and associated risk factors affect subclinical myocardial structure and function in pediatric patients compared to healthy controls?
Pediatric kidney transplant recipients exhibit subclinical myocardial dysfunction and left ventricular hypertrophy despite preserved ejection fraction, which is strongly associated with hypertension and graft function.
Absolute Event Rate: -20.64% vs -21.78%
p-value: p=0.002
BACKGROUND: Kidney transplantation (KTx) improves prognosis in children with kidney failure; still, these patients are prone to cardiovascular damage due to multiple risk factors. Our aim was to assess myocardial structure and function in pediatric KTx by conventional and speckle-tracking echocardiography (STE) in association with established cardiovascular risk factors. METHODS: Forty-two KTx and 39 healthy age- and gender-matched children were evaluated. KTx recipients were further categorized according to the control of hypertension assessed by 24-h ambulatory blood pressure monitoring (ABPM). Subjects underwent pulse wave velocity (PWV) measurement, conventional echocardiography, and 2-dimensional STE. Left and right ventricular (LV, RV) global longitudinal strain (GLS), and LV circumferential strain (GCS) were measured. Glomerular filtration rate (eGFR) was calculated according to the Schwartz formula. RESULTS: KTx patients had increased blood pressure and arterial stiffness. LV ejection fraction (EF) was preserved along with elevated LV mass index (LVMi) while LVGLS was significantly lower, whereas LVGCS and RVGLS were increased in KTx. Uncontrolled hypertensives had lower LVGLS compared to those with controlled hypertension. Using multiple forward stepwise regression analysis, 24-h SBP and relative wall thickness (RWT) were independent determinants of LVMi, whereas antihypertensive therapy, eGFR, and HOMA-IR were independent determinants of LVGLS. CONCLUSIONS: Cardiac morphology and function show distinct changes after KTx. Along with comparable ventricular volumes, LV hypertrophy and subclinical myocardial dysfunction are present. Control of hypertension and kidney graft function are major factors of LV performance. STE may be useful to reveal early myocardial dysfunction in pediatric KTx. A higher resolution version of the Graphical abstract is available as Supplementary information.
Bárczi et al. (Tue,) conducted a cross-sectional in Pediatric kidney transplant recipients (n=81). Kidney transplantation vs. Healthy age- and gender-matched children was evaluated on Left ventricular global longitudinal strain (LVGLS) (p=0.002). Pediatric kidney transplant recipients exhibited subclinical myocardial dysfunction with significantly impaired left ventricular global longitudinal strain (-20.64% vs -21.78%) compared to healthy controls.
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