title: Improved Left Ventricular Structure and Function After Successful Kidney Transplantation.
abstract: OBJECTIVE
  Cardiac changes observed in chronic kidney disease patients are of multifactorial origin including chronic uremia, hemodynamics or inflammation. Restoration of renal function by kidney transplantation (KTX) may reverse cardiac changes. Novel echocardiographic methods such as speckle tracking echocardiography (STE) allow early and sensitive detection of subtle changes of cardiac parameters. We evaluated changes of cardiac structure and function after KTX by advanced echocardiographic modalities.
  
  
  METHODS
  Thirty-one KTX recipients (female n=11) were evaluated by medical examination, laboratory testing and echocardiography before and after KTX (median follow-up 19 months). Left ventricular (LV) and right ventricular (RV) diameters and function were assessed by echocardiographic standard parameters. Longitudinal 2D strain of the LV (GLPS) and left atrium (LA) was determined by 2D STE.
  
  
  RESULTS
  After KTX, median serum creatinine level was 1.3 mg/dl (IQR, 1.2-1.5). Systolic blood pressure decreased significantly after KTX. Echocardiography showed a significant reduction in LV end-diastolic septal and posterior wall thickness and LV mass index after KTX, which was accompanied by an improvement of GLPS. There were no relevant changes in parameters of LA (reservoir, conduit or contractile) function, LV diastolic or RV function after KTX.
  
  
  CONCLUSIONS
  LV hypertrophy reversed after successful KTX and was accompanied by an improvement in longitudinal LV function as assessed by STE. Diastolic function and STE-derived LA function parameters did not change significantly after KTX.
authors.affiliation: Medizinische Klinik m.S. Kardiologie und Angiologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hewing
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Dehn
authors.forename: Oliver
authors.initials: O
authors.lastname: Staeck
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Spethmann
authors.forename: Karl
authors.initials: K
authors.lastname: Stangl
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Henryk
authors.initials: H
authors.lastname: Dreger
authors.forename: Klemens
authors.initials: K
authors.lastname: Budde
authors.forename: Fabian
authors.initials: F
authors.lastname: Halleck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D005260:Female; D006085:Graft Survival; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D018487:Ventricular Dysfunction, Left / Q000473:pathology*; D055815:Young Adult