Determinants of Left Ventricular Characteristics Assessed by Cardiac Magnetic Resonance Imaging and Cardiovascular Biomarkers Related to Kidney Transplantation

Prasad, G. V. Ramesh; Yan, Andrew T.; Nash, Michelle M.; Kim, S Joseph; Wald, Ron; Wald, Rachel M.; Gunaratnam, Lakshman; Karur, Gauri Rani; Kirpalani, Anish; Connelly, Philip W.

doi:10.1177/2054358118809974

Cited by 16 publications

(40 citation statements)

References 47 publications

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“…In the CMR evaluation, considering ventricular function, volume and mass, we did not find differences at 6 months, similar to Patel [34] and Prasad et al [35]. Patel performed the first study to serially evaluate the LVs of patients who have undergone kidney transplantation using CMR.…”

Section: Discussionsupporting

confidence: 86%

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Contti

Barbosa

Maurício

et al. 2019

Journal of Cardiovascular Magnetic Resonance

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Background The measurement of native T1 through cardiovascular magnetic resonance (CMR) is a noninvasive method of assessing myocardial fibrosis without gadolinium contrast. No studies so far have evaluated native T1 after renal transplantation. The primary aim of the current study is to assess changes in the myocardium native T1 6 months after renal transplantation. Methods We prospectively evaluated 44 renal transplant patients with 3 T CMR exams: baseline at the beginning of transplantation and at 6 months after transplantation. Results The native T1 time was measured in the midventricular septum and decreased significantly from 1331 ± 52 ms at the baseline to 1298 ± 42 ms 6 months after transplantation ( p = 0.001). The patients were split into two groups through a two-step cluster algorithm: In cluster-1 ( n = 30) the left ventricular (LV) mass index and the prevalence of diabetes were lower. In cluster-2 ( n = 14) the LV mass index and diabetes prevalence were higher. Decrease in native T1 values was significant only in the patients in cluster-1 ( p = 0.001). Conclusions The native myocardial T1 time decreased significantly 6 months after renal transplant, which may be associated with the regression of the reactive fibrosis. The patients with greater baseline LV mass index and the diabetic group did not reach a significant decrease in T1. Electronic supplementary material The online version of this article (10.1186/s12968-019-0531-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Contti

Barbosa

Maurício

et al. 2019

Journal of Cardiovascular Magnetic Resonance

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“…The recruitment of participants for this study has been described [14, 13]. The study sample size target of 42 subjects per group was designed to detect a 5 µg/ml change in adiponectin, with expected attrition of 20%.…”

Section: Methodsmentioning

confidence: 99%

“…We have recently reported the left ventricular changes in patients on dialysis receiving a kidney transplant. While both left ventricular volume and adiponectin levels decreased with a kidney transplant, the change in adiponectin level and the change in HDL cholesterol were not associated with the change in left ventricular volume [13]. CMR is, therefore, a useful tool to correlate biomarker changes after transplantation with measurable changes in cardiac function.…”

Section: Introductionmentioning

confidence: 99%

The increase in paraoxonase-1 is associated with a decrease in left ventricular volume in kidney transplant recipients

Connelly

et al. 2020

Preprint

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Background: Patients on dialysis have impaired cardiac function, in part due to increased fluid volume and ventricular stress. Restored kidney function through transplantation reduces left ventricular volume in both systole and diastole. Paraoxonase 1 (PON1) is reduced in patients on dialysis, which may be related to their impaired cardiac function. We tested the hypothesis that change in PON1 is associated with changes in left ventricular (LV) end-volume and LV mass after kidney transplantation. Methods: Patients were studied before and 12 months after kidney transplantation. The control group was patients on dialysis not expected to receive a transplant in the next 12 months. Cardiac magnetic resonance imaging was used to measure LV end-diastolic and end-systolic volume and LV mass. PON1 was measured by arylesterase activity and by mass. Results: PON1 mass and activity were not different between the groups at baseline. Both PON1 mass and activity were increased post-kidney transplantation (p<0.0001 for change). The change in PON1 mass (p=0.0062) and PON1 arylesterase activity (p=0.0254) were inversely correlated with the change in NT-proBNP for patients receiving a kidney transplant. However, only the change in the PON1 mass, but not the change in PON1 arylesterase, was inversely correlated with the change in left ventricular volume (ml/m2.7) (p=0.0146 and 0.0114 for diastolic and systolic, respectively) and with the change in hemoglobin (p=0.0042). Conclusions: PON1 mass and activity increase after kidney transplantation. The increase in PON1 mass is consistent with a novel relationship to the increase in hemoglobin and the decrease in LV end-systolic and end-diastolic volume.

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“…All three CMR studies reported no significant overall change in LVMI. [48][49][50] However, the trends in mean change were conflicting. Patel et al 49 observed an increase in LVMI in transplant recipients and a decrease in the control group of haemodialysis patients (À3.6 ± 16.7%/year vs. 2.75 ± 9.1%/year).…”

Section: Left Ventricular Mass Indexmentioning

confidence: 99%

Changes in left ventricular structure and function associated with renal transplantation: a systematic review and meta‐analysis

et al. 2021

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Aims This study aimed to examine if the cardiac changes associated with uraemic cardiomyopathy are reversed by renal transplantation. Methods and results MEDLINE, Embase, OpenGrey, and the Cochrane Library databases were searched from 1950 to March 2020. The primary outcome measure was left ventricular mass index. Secondary outcome measures included left ventricular dimensions and measures of diastolic and systolic function. Studies were included if they used any imaging modality both before and after successful renal transplantation. Data were analysed through meta-analysis approaches. Weight of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation system. Twenty-three studies used echocardiography, and three used cardiac magnetic resonance imaging as their imaging modality. The methodological quality of the evidence was generally poor. Four studies followed up control groups, two using cardiac magnetic resonance imaging and two using echocardiography. Meta-analysis of these studies indicated that there was no difference in left ventricular mass index between groups following transplantation {standardized mean difference À0.07 [95% confidence interval (CI) À0.41 to 0.26]; P = 0.67}. There was also no difference observed in left ventricular ejection fraction [mean difference 0.39% (95% CI À4.09% to 4.87%); P = 0.86] or left ventricular end-diastolic volume [standardized mean difference À0.24 (95% CI À0.94 to 0.45); P = 0.49]. Inconsistent reporting of changes in diastolic dysfunction did not allow for any meaningful analysis or interpretation. Conclusions The evidence does not support the notion that uraemic cardiomyopathy is reversible by renal transplantation. However, the evidence is limited by methodological weaknesses, which should be considered when interpreting these findings.

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Determinants of Left Ventricular Characteristics Assessed by Cardiac Magnetic Resonance Imaging and Cardiovascular Biomarkers Related to Kidney Transplantation

Cited by 16 publications

References 47 publications

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

The increase in paraoxonase-1 is associated with a decrease in left ventricular volume in kidney transplant recipients

Changes in left ventricular structure and function associated with renal transplantation: a systematic review and meta‐analysis

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