title: Tissue Doppler Imaging and Intima-Media Thickness as Noninvasive Methods of Cardiovascular Risk Stratification in Patients After Kidney Transplantation.
abstract: BACKGROUND
  Cardiovascular complications, including coronary artery disease and chronic heart failure, are the leading causes of death in patients with chronic kidney disease. New echocardiographic techniques, such as tissue Doppler imaging (TDI) with strain and strain rate, are noninvasive, easy-to-perform methods of the estimation of left ventricular (LV) systolic and diastolic function. The aim of the study was to analyze the utility of new noninvasive methods of cardiovascular risk stratification in patients after kidney transplantation.
  
  
  METHODS
  We included 43 consecutive kidney transplant (KT) recipients, with 30 healthy subjects constituting the control group in the study. We evaluated LV morphology and LV systolic and diastolic function by means of echocardiography with TDI and intima-media thickness by ultrasonography of the carotid arteries.
  
  
  RESULTS
  LV mass index was significantly higher in transplanted patients, and both mitral inflow E/A and Em/Am ratios from pulsed myocardial imaging were significantly lower in the KT group as compared with the control group. The systolic wave of TDI at the basal segments was much lower in KT patients than in the control patients (P < .05). The mean value of strain rate was reduced in KT recipients as compared with the control patients. IMT was significantly higher in KT recipients.
  
  
  CONCLUSIONS
  Echocardiography with TDI provided more accurate information about systolic and diastolic LV function. KT recipients showed significant alterations in LV longitudinal myocardial function parameters estimated by strain and strain rate. Strain and strain rate are noninvasive methods, easy to repeat, and valuable for detecting myocardial LV dysfunction in asymptomatic KT recipients.
authors: Noninvasive Cardiac Diagnostic Department, Medical University of Gdańsk, Poland. Electronic address: mdudziak@gumed.edu.pl.
authors: M
authors: M
authors: Dudziak
authors: Noninvasive Cardiac Diagnostic Department, Medical University of Gdańsk, Poland.
authors: D
authors: D
authors: Rawicz-Zegrzda
authors: Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Poland.
authors: M
authors: M
authors: Jankowska
authors: Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Poland.
authors: A
authors: A
authors: Dębska-Ślizień
authors: Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Poland.
authors: Z
authors: Z
authors: Wołyniec
authors: Department of Nephrology, Transplantology, and Internal Medicine, Medical University of Gdańsk, Poland.
authors: B
authors: B
authors: Rutkowski
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D066027:Transplant Recipients; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left