The effect of kidney transplant on cardiac function: An echocardiographic perspective

Kidney transplant (KT) resolves many of the cardiac abnormalities associate d with chronic kidney failure (CKF). This study analyzed cardiac alteration s of kidney failure and their modification with transplant. Thirteen patien ts in CKF underwent conventional echocardiograms, dobutamine stress echocar diograms, and injection of contrast to examine perfusion before KT and 3 mo nths after transplant. Nine patients had evidence of left ventricular hyper trophy and six had evidence of diastolic dysfunction. Wall thickness, left ventricular mass, and mass index diminished after KT; only two patients con tinued to manifest hypertrophy. Left ventricular systolic diameters and vol umes diminished at 3 months, and diastolic diameters after 4 months. Left v entricular fractional shortening and ejection fraction increased 3 months a fter transplant. At the end of the study, only two patients continued to sh ow diastolic dysfunction. Dobutamine echocardiograms showed no segmental wa ll-movement abnormalities. Myocardial perfusion was normal before and after transplant. The results suggest that KT diminishes hypertrophy and improve s left ventricular systolic and diastolic function. Echocardiography provid es valuable information for detection and follow-up of cardiac abnormalitie s in patients with kidney disease. Evaluation of segmental wall movement an d myocardial perfusion aid in demonstrating that our studied patients with CKF had no indirect signs of coronary artery disease.