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Int J Cardiol. 2018 Dec 1;272:323-328. doi: 10.1016/j.ijcard.2018.07.088. Epub 2018 Jul 22.

Reduced global longitudinal strain is associated with increased risk of cardiovascular events or death after kidney transplant.

Author information

1
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA; Noninvasive Cardiovascular Imaging Section, Department of Radiology and Cardiovascular Division of the Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: kfujikura@bwh.harvard.edu.
2
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA. Electronic address: bpeltzer@montefiore.org.
3
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA; Division of Cardiology, Department of Medicine, Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY 10461, USA.
4
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA.
5
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA. Electronic address: sanyog.shitole@einstein.yu.edu.
6
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA. Electronic address: jorge.kizer@einstein.yu.edu.
7
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210 Street, Bronx, NY 10467, USA. Electronic address: mariogar@montefiore.org.

Abstract

BACKGROUND:

Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant.

METHOD:

Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant. Medical records were evaluated for demographics and patient characteristics. Echocardiograms were analyzed for conventional measurements, and GLS was assessed using speckle-tracking analysis.

RESULTS:

The median age of the study sample was 54 years. Overall, 60% were men; 35% were non-Hispanic black, and 50% Hispanic. After a mean follow-up of 3.8 ± 0.5 years, there were 21 cardiovascular events or deaths. Patients who experienced an event were older, more frequently had a history of coronary artery disease, and had higher LV filling/longitudinal diastolic annular velocity (E/e') than those who did not. GLS was significantly associated with event-free survival even after adjusting for age, sex, race-ethnicity, hypertension, diabetes, history of coronary artery disease or heart failure, and E/e'.

CONCLUSION:

Reduced GLS peri-transplant is significantly associated with increased CVD events or death after kidney transplant. Larger studies are required to determine the incremental predictive value of GLS over clinical and other echocardiographic parameters for adverse CVD events following renal transplantation.

KEYWORDS:

Echocardiogram; Global longitudinal strain; Kidney transplant; Post-transplant events; Speckle-tracking

PMID:
30082119
PMCID:
PMC6325639
DOI:
10.1016/j.ijcard.2018.07.088
[Indexed for MEDLINE]
Free PMC Article

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