Noninvasive assessment of left ventricular function prior to and 6 months after renal transplantation.
BACKGROUND
The purpose of this study was to evaluate the effect of a successful kidney transplantation on left ventricular functional parameters that can be measured with gated-single photon emission computed tomography (gated-SPECT) myocardial perfusion scintigraphy in patients with end-stage renal disease.


METHODS
Thirty-two consecutive patients (22 male) who had undergone a successful kidney transplantation in whom gated-SPECT myocardial perfusion scintigraphy was performed prior to and 6 months after surgery were included. Functional parameters, such as left ventricular ejection fraction (LVEF), wall motion, and wall thickening, were calculated with quantitative gated-SPECT.


RESULTS
The mean LVEF improved significantly (P<.001) from 52% (SD+/-11) before to 63% (SD+/-10) after renal transplantation. This was attributable to a significant improvement in the end-systolic volume (P=.028). Wall motion and wall thickening improved in almost all myocardial segments. We found a significant correlation between the levels of urea and creatinine and the LVEF. However, correlations between an increase in the LVEF and the improvement in urea (P=.30) and creatinine (P=.26) levels were not significant, which is probably related to the number of patients studied.


CONCLUSIONS
The systolic left ventricular dysfunction in terms of LVEF, wall motion, and wall thickening improves significantly 6 months after kidney transplantation in patients with end-stage kidney disease. Long-term follow-up is required to establish the prognostic value of these findings.
Stokkel
M
M
Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Duchateau
C S
CS
Jukema
W
W
de Fijter
H W
HW
D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left / Q000502:physiology*