Defining the predictors for post renal transplant left ventricular dysfunction in end-stage renal disease patients

Abstract

Reduced left ventricular (LV) function predicts poor outcomes in end-stage renal disease (ESRD). This study aimed to identify the pre-renal transplantation echocardiographic parameters that can predict post-renal transplantation LV failure. This prospective longitudinal study was conducted on patients with ESRD who underwent renal transplantation during 1 year. All patients underwent echocardiography, including ejection fraction (EF), global longitudinal strain (GLS), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic diameter (LVEDD), interventricular septal (IVS) thickness, peak velocity of early diastolic transmitral flow (E), peak velocity of late transmitral flow (A), early diastolic myocardial relaxation (Em), E/A, E/Em, Left atrial volume (LAV) index, tricuspid regurgitation peak gradient (TRPG), systolic pulmonary artery pressure (SPAP), tricuspid annular plane systolic excursion (TAPSE), 1 week before and 1 month after renal transplantation. Fifty patients participated in the current study. All echocardiographic parameters improved after transplantation. Post-renal transplantation LV dysfunction was observed in 21 (42%) patients. Pre-renal transplantation echocardiographic parameters (LVEDV, LVESD, LVEDD, IVS, E/Em, TRPG, SPAP, and LAV index) could predict post-transplantation LV failure with high accuracy (AUC: 0.978).