Cardiovascular outcomes in renal transplant recipients: Feasibility and clinical role of 2D speckle tracking to assess myocardial function

Abstract

Left ventricular (LV) function is normally improved after renal transplant; however, cardiovascular mortality remains elevated. Moderate physical activity has a positive impact on myocardial function; however, few data are available about the role of 2D echocardiography (2DE) and 2D speckle tracking echocardiography (2DSTE) on renal transplant recipients (RTR). From a large cohort of RTR submitted to a supervised exercise as the prescription program, 10 subjects who were regularly trained were studied for sixth months. They underwent periodically an echo evaluation (ESAOTE MyLab 50), cardiopulmonary test (CPT) and strength test for the lower and upper limbs. The LV function study was completed with the speckle tracking longitudinal strain (Lo Strain) measure calculated by dedicated software (XStrain–Esaote) at the end of the protocol. All of the cardiovascular parameters were normal: the ejection fraction (EF) increased significantly (from 62.7 ± 4 to 67.2 ± 2.3 with p < 0.05), as well as the anaerobic threshold (15.3 ± 6.8 to 20.5 ± 10.1 with p < 0.05). Particularly, the global longitudinal strain (GLS) values were within the normal range (-19.2% ± 5.1), maintaining the physiological gradient from the basal (-13.2 ± 4.1; -16.5 ± 5.21) to the apex level (-21 ± 2.3; -25.7 ± -7.0). 2D speckle tracking echocardiography (2DSTE) can be effectively used to confirm the presence of preserved physiological myocardial function in post-renal transplantation subjects submitted to a physical training.