The reverse remodeling of the aorta in patients after renal transplantation - the value of aortic stiffness index: prospective echocardiographic study

Abstract

BackgroundAtherosclerosis is regarded as a combination of two major separate diseases: atherosis and sclerosis. Sclerotic component depends on deterioration of elastic properties of the aortic wall and is called aortic stiffness. The most valuable, non-invasive method of aortic stiffness assessment is echocardiography, which allows to calculate the aortic stiffness index (ASI). ASI is an independent predictor of all-cause and cardiovascular mortality in different groups of patients. The main aim of study was the assessment of the aortic reverse remodeling in patients with end-stage renal disease (ESRD) after renal transplantation (RT).MethodsStudy group involved 42 patients aged 43.3 ± 12.6 years, including 19 women aged 49.9 ± 10.9 years and 23 men aged 41.5 ± 12.91 years, who have undergone RT from non-related renal transplant donors, The study protocol has been consisted of 5 stages: 1 week after RT, 3 months after RT, 6 months after RT, 1 year after RT and 3 years after RT. The echocardiographic examination was performed and measurements of Aomax, Aomin were done. On the base of obtained parameters ASI, aortic distensibility (AD) and aortic strain (AS) were calculated according to adequate formulas.ResultsThe improvement of indices characterizing the elastic properties of aorta were noted. These changes attained the statistically significant level only at the end of the observation. ASI just after RT was equal – 4.65 ± 1.58, three months after RT – 4.54 ± 1.49, six months after RT – 4.59 ± 1.61, one year after RT – 4.35 ± 1.21 and three years after RT – 3.35 ± 1.29, while AD reached respectively – 6.55 ± 3.76 cm2/dyn−110−6 just after RT, − 6.38 ± 3.42 cm2/dyn−110−6 three months after RT, − 6.53 ± 3.60 cm2/dyn−110−6 six months after RT, − 6.48 ± 2.79 cm2/dyn−110−6 one year after RT and – 8.03 ± 3.95 cm2/dyn−110−6 three years after RT. Noted AS values were equal – 6.61 ± 4.05%, just after RT, − 6.40 ± 3.58% three months after RT, − 6.56 ± 3.76%, six months after RT, − 6.45 ± 2.80% one year after RT, − 8.01 ± 3.97%. and three years after RT. The exact analysis of parameters concerning aortic function showed that to achieve ASI, AD and AS improvement, long time was needed, because the most significant changes of these indices were observed only between 1 year and 3 years after RT.ConclusionsThere is a relationship between renal transplantation and improvement of the aortic elastic properties. The recovery of the renal function allows to initiate the reparative processes leading to at least partial restitution of the structure and features of the aorta, which is called reverse remodelling. Improvement of aortic wall elastic properties after renal transplantation is a continuous and prolonged process.

The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis

“…Transthoracic echocardiographic examination was performed (according to the recommendations of the American Society of Echocardiography) by an cardiologist, who was blinded to the clinical data of the study subjects [23, 24]. On the basis of the planimetric measurements, the following parameters were calculated: left ventricle endsystolic and enddialstolic volumes (LVESV and LVEDV, respectively), left ventricle stroke volume (SV), stroke index (SI), cardiac output (CO), cardiac index (CI), left ventricle ejection fraction (EF), left ventricle mass (LVM), and left ventricle mass index (LVMI), left atrial volume (LAV), LA volume index (LAVI).…”

Assessment of Aortic Elasticity and the Doppler Tissue Echocardiography in Thalassemia Major Children

“…In this regard, Bektaş et al 6 found a significant change in asthmatic patients compared with posttreatment asthmatic patients. Prenner and Chirinos, 7 Zapolski et al, 8 and Sahin et al 9 found an increase of arterial stiffness parameters in diabetes mellitus, end stage renal and thalassemia major (TM) diseases compared with healthy in the order given. In addition, considering TM patients, Sherief et al 10 used the method of carotid artery intima media thickness and found a significant increase, while Cusmà Piccione et al 11 did not find.…”

“…2 Many studies have been conducted about the aortic elastic changes due to various diseases. [4][5][6][7][8][9][10][11] Bayar et al 4 found changes in arterial stiffness parameters in patients with celiac diseases compared with the healthy when Ülger et al 5 did not find any changes in asthma patients. In this regard, Bektaş et al 6 found a significant change in asthmatic patients compared with posttreatment asthmatic patients.…”

Aortic stiffness—Is kynurenic acid a novel marker? Cross-sectional study in patients with persistent atrial fibrillation

“…with dyslipidemia or metabolic syndrome [9,10]. Furthermore, conditions such as hyperuricemia or hyperhomocysteinemia, possibly via generation of free radicals and increased inflammation, can promote the deterioration of structure and function of arterial wall [11][12][13].…”