J Cardiovasc Ultrasound.  2013 Dec;21(4):171-176. 10.4250/jcu.2013.21.4.171.

Left Ventricular Torsion Changes Post Kidney Transplantation

• Deng Y
• Pandit A
• Heilman RL
• Chakkera H
• Mazur MJ
• Mookadam F

• KMID: 2135415
• DOI: http://doi.org/10.4250/jcu.2013.21.4.171

Abstract

BACKGROUND
To quantify changes of left ventricular (LV) torsion in patients' pre and post kidney transplantation.
METHODS
A prospective study was conducted on 48 patients who received kidney transplantation for end stage renal disease and without myocardial infarction. The rotation, twist and torsion of LV were studied pre and post kidney transplantation (6 months post transplantation) using velocity vector imaging by echocardiography. The data is expressed as mean +/- standard deviation and compared by paired t-test at the p < 0.05 significance level.
RESULTS
Six months post kidney transplantation, left ventricular ejection fraction (from 40.33 +/- 11.42 to 61.00 +/- 13.68%), ratio of mitral early and late diastolic filling velocity (from 1.04 +/- 0.57 to 1.21 +/- 0.52), rotation of basal LV (from 4.48 +/- 2.66 to 5.65 +/- 2.64 degree), rotation of apical LV (from 4.27 +/- 3.08 to 5.50 +/- 4.25 degree), LV twist (8.75 +/- 4.45 to 11.14 +/- 5.25 degree) and torsion (from 1.06 +/- 0.54 to 1.33 +/- 0.61 degree/cm) were increased significantly (p < 0.05). Interventricular septum thickness (from 11.67 +/- 2.39 to 9.67 +/- 0.48 mm), left ventricular mass index (from 104.00 +/- 16.47 to 95.50 +/- 21.44 g/m2), systolic blood pressure (from 143.50 +/- 34.99 to 121.50 +/- 7.09 mmHg), serum blood urea nitrogen (from 42.40 +/- 7.98 to 30.43 +/- 13.85 mg/dL) and creatinine (from 4.53 +/- 1.96 to 2.73 +/- 2.57 mg/dL) were decreased significantly (p < 0.05).
CONCLUSION
Kidney transplantation in end stage renal disease without myocardial infarction results in improvement in left ventricular structure, function and myocardial mechanics as detected by echocardiography and velocity vector imaging. Velocity vector imaging provided valuable information for detection and follow-up of cardiac abnormalities in patients with end stage renal disease.

Keyword

Cardiac mechanics; Kidney transplant; Echocardiography

MeSH Terms

Blood Pressure
Blood Urea Nitrogen
Creatinine
Echocardiography
Humans
Kidney Failure, Chronic
Kidney Transplantation*
Kidney*
Mechanics
Myocardial Infarction
Prospective Studies
Stroke Volume
Creatinine

Figure

• 

  Fig. 1 Left ventricular rotation pre and post kidney transplantation. A: Left ventricular rotation at apex pre kidney transplantation. B: Left ventricular rotation at base pre kidney transplantation. C: Left ventricular rotation at apex post kidney transplantation. D: Left ventricular rotation at base post kidney transplantation.

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