A sportolói teljesítmény kardiális vonatkozásainak vizsgálata(K 135076) Támogató:
NKFIA
(FK 142573) Támogató: NKFIH
(RRF-2.3.1-21-2022-00003)
(TKP2021-EGA-23) Támogató: Innovációs és Technológiai Minisztérium
Szakterületek:
Szív és érrendszer
Background: Kidney transplantation (KTX) markedly improves prognosis in pediatric
patients with end-stage kidney failure. Still, these patients have an increased risk
of developing cardiovascular disease due to multiple risk factors. Three-dimensional
(3D) echocardiography allows detailed assessment of the heart and may unveil distinct
functional and morphological changes in this patient population that would be undetectable
by conventional methods. Accordingly, our aim was to examine left- (LV) and right
ventricular (RV) morphology and mechanics in pediatric KTX patients using 3D echocardiography.
Materials and Methods: Pediatric KTX recipients (n=74) with median age 20 [14-26]
years at study enrollment (43% female), were compared to 74 age and gender-matched
controls. Detailed patient history was obtained. After conventional echocardiographic
protocol, 3D loops were acquired and measured using commercially available software
and the ReVISION Method. We measured LV and RV end-diastolic volumes indexed to body
surface area (EDVi), ejection fraction (EF), and 3D LV and RV global longitudinal
(GLS) and circumferential strains (GCS). Results: Both LVEDVi (67±17 vs. 61±9 mL/m2;
p<0.01) and RVEDVi (68±18 vs. 61±11 mL/m2; p<0.01) were significantly higher in KTX
patients. LVEF was comparable between the two groups (60±6 vs. 61±4 %; p=NS), however,
LVGLS was significantly lower (-20.5±3.0 vs. -22.0±1.7 %; p<0.001), while LVGCS did
not differ (-29.7±4.3 vs. -28.6±10.0 %; p=NS). RVEF (59±6 vs. 61±4 %; p<0.05) and
RVGLS (-22.8±3.7 vs. -24.1±3.3 %; p<0.05) were significantly lower, however, RVGCS
was comparable between the two groups (-23.7±4.5 vs. -24.8±4.4 %; p=NS). In patients
requiring dialysis prior to KTX (n=64, 86 %) RVGCS showed correlation with the length
of dialysis (r=0.32, p<0.05). Conclusions: Pediatric KTX patients demonstrate changes
in both LV and RV morphology and mechanics. Moreover, the length of dialysis correlated
with the contraction pattern of the right ventricle.
