Electrocardiographic changes before and after successful kidney transplantation and associations with cardiovascular and mortality outcomes

Paajanen, Hanna; Helanterä, Ilkka; Kaartinen, Kati; Nikus, Kjell; Eskola, Markku; Groop, Per‐Henrik; Koskinen, Petri

doi:10.1111/ctr.13242

Cited by 2 publications

(1 citation statement)

References 31 publications

(31 reference statements)

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“…This study focused on a special population of patients with a history of solid organ transplantation who were asymptomatic, at least in at-rest conditions. Sports medicine has been recently involved in the evaluation of certain categories using ECG and echocardiographic parameters [7,9,17,18]. A wide range of subjects with non-communicable diseases started participating in structured physical activity programs known as "exercise prescription".…”

Section: Discussionmentioning

confidence: 99%

The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients

Stefani,

Orlandi,

Corsi

et al. 2023

Sci

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Background: Transplanted patients are frail individuals who may be affected by diastolic dysfunction, leading to a decrease in exercise tolerance. Previous studies have reported that certain ECG and echocardiographic parameters (such as the P-wave interval, PQ interval, P-wave dispersion, Tend-P interval, QTc interval, and strain) can support the diagnosis of diastolic dysfunction when the ejection fraction is preserved. This study aimed to examine the potential diagnostic contribution of specific ECG and deformation parameters in transplanted recipients, who are at a high risk of heart failure. Materials and Methods: A group of 33 transplanted subjects (17 renal and 16 liver) were categorized using two scores for heart failure with preserved ejection fraction (HFpEF). Additionally, they underwent evaluation based on ECG parameters (P-wave interval, PQ interval, Pwave dispersion, and Tend-P QTc) and echocardiographic deformation parameters (strain and twist). The Student’s t-test was used for statistical analysis. Results: The two scores identified different numbers of excludable and not excludable subjects potentially affected by HFpEF. The not excludable group presented ECG parameters with significantly higher values (P-wave, PQ interval, posterior wall diastole, and Tend-P, all with p ≤ 0.05) and significantly lower 4D strain and twist values (p < 0.05) Conclusions: There is evidence for a significant diagnostic contribution of additional ECG and echo strain parameters in an early phase of diastolic dysfunction in subjects potentially affected by HFpEF.

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Section: Discussionmentioning

confidence: 99%

The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients

Stefani,

Orlandi,

Corsi

et al. 2023

Sci

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Experimental renal transplantation in rats improves cardiac dysfunction caused by chronic kidney disease while LVH persists

Hagmayer,

Mayer,

Ebert

et al. 2023

Front. Cardiovasc. Med.

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BackgroundChronic kidney disease (CKD) causes congestive heart failure (CHF) with systolic dysfunction and left ventricular hypertrophy (LVH), which is a major contributor to increased mortality in CKD patients. It remains unclear whether cardiovascular changes that occur during the course of CKD can be reversed when renal function is restored by transplantation.MethodsTo investigate this, chronic kidney disease was established in F344 rats by subtotal nephrectomy (SNx) for 8 weeks, followed by transplantation of a functional kidney from an isogenic F344 donor. SNx rats without transplantation and sham-operated animals served as controls. Renal function was assessed before and throughout the experiment. In addition, cardiac ultrasound was performed at weeks 0, 8, 12 and 16. At the end of the experiment, intra-arterial blood pressure was measured and kidneys and hearts were histologically and molecularly examined.ResultsEight weeks after SNx, rats developed marked renal dysfunction associated with significant glomerulosclerosis and tubulointerstitial fibrosis, but also an increase in left ventricular mass. After transplantation, renal function normalized but relative heart weight and ventricular mass as assessed by ultrasound scans showed no reduction compared with SNx controls. However, left ventricular wall thickness, fractional shortening and ejection fraction was normalized by renal transplantation. At 8 weeks after kidney transplantation, cardiac expression of BNP and FGF23 was also at levels comparable to healthy controls, whereas these factors were significantly increased in SNx rats. Cardiac fibrosis, as measured by fibronectin mRNA expression, was completely normalized, whereas cardiac fibronectin protein was still slightly but not significantly increased in transplanted animals compared to controls. In addition, the myofibroblast marker collagen 1, as assessed by immunohistochemistry, was significantly increased in SNx rats and also normalized by renal transplantation. Interestingly, CD68+ macrophages were significantly reduced in the hearts of SNx rats and in transplanted animals at slightly higher levels compared to controls.ConclusionRestoration of renal function by kidney transplantation normalized early cardiac changes at most functional and molecular levels, but did not completely reverse LVH. However, further studies are needed to determine whether restoration of renal function can also reverse LVH at a later time point.

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Electrocardiographic changes before and after successful kidney transplantation and associations with cardiovascular and mortality outcomes

Abstract: Careful analysis of the ECG before transplantation can be used to estimate cardiovascular events and mortality risk after kidney transplantation.

Cited by 2 publications

References 31 publications

The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients

The Additional Diagnostic Value of Electrocardiogram and Strain Patterns in Transplanted Patients

Experimental renal transplantation in rats improves cardiac dysfunction caused by chronic kidney disease while LVH persists

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