Reduced global longitudinal strain is associated with increased risk of cardiovascular events or death after kidney transplant

Kana Fujikura, Bradley Peltzer, Nidhish Tiwari, Hye Gi Shim, Ally B. Dinhofer, Sanyog G. Shitole, Jorge Kizer, Mario J. Garcia

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant. Method: Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant. Medical records were evaluated for demographics and patient characteristics. Echocardiograms were analyzed for conventional measurements, and GLS was assessed using speckle-tracking analysis. Results: The median age of the study sample was 54 years. Overall, 60% were men; 35% were non-Hispanic black, and 50% Hispanic. After a mean follow-up of 3.8 ± 0.5 years, there were 21 cardiovascular events or deaths. Patients who experienced an event were older, more frequently had a history of coronary artery disease, and had higher LV filling/longitudinal diastolic annular velocity (E/e’) than those who did not. GLS was significantly associated with event-free survival even after adjusting for age, sex, race-ethnicity, hypertension, diabetes, history of coronary artery disease or heart failure, and E/e’. Conclusion: Reduced GLS peri-transplant is significantly associated with increased CVD events or death after kidney transplant. Larger studies are required to determine the incremental predictive value of GLS over clinical and other echocardiographic parameters for adverse CVD events following renal transplantation.

Original languageEnglish (US)
JournalInternational Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Transplants
Cardiovascular Diseases
Kidney
Coronary Artery Disease
Chronic Renal Insufficiency
Hispanic Americans
Kidney Transplantation
Disease-Free Survival
Medical Records
Heart Failure
Demography
Hypertension
Therapeutics

Keywords

  • Echocardiogram
  • Global longitudinal strain
  • Kidney transplant
  • Post-transplant events
  • Speckle-tracking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Reduced global longitudinal strain is associated with increased risk of cardiovascular events or death after kidney transplant. / Fujikura, Kana; Peltzer, Bradley; Tiwari, Nidhish; Shim, Hye Gi; Dinhofer, Ally B.; Shitole, Sanyog G.; Kizer, Jorge; Garcia, Mario J.

In: International Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

@article{54064d888bfa42ff934230d792f034e7,
title = "Reduced global longitudinal strain is associated with increased risk of cardiovascular events or death after kidney transplant",
abstract = "Background: Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant. Method: Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant. Medical records were evaluated for demographics and patient characteristics. Echocardiograms were analyzed for conventional measurements, and GLS was assessed using speckle-tracking analysis. Results: The median age of the study sample was 54 years. Overall, 60{\%} were men; 35{\%} were non-Hispanic black, and 50{\%} Hispanic. After a mean follow-up of 3.8 ± 0.5 years, there were 21 cardiovascular events or deaths. Patients who experienced an event were older, more frequently had a history of coronary artery disease, and had higher LV filling/longitudinal diastolic annular velocity (E/e’) than those who did not. GLS was significantly associated with event-free survival even after adjusting for age, sex, race-ethnicity, hypertension, diabetes, history of coronary artery disease or heart failure, and E/e’. Conclusion: Reduced GLS peri-transplant is significantly associated with increased CVD events or death after kidney transplant. Larger studies are required to determine the incremental predictive value of GLS over clinical and other echocardiographic parameters for adverse CVD events following renal transplantation.",
keywords = "Echocardiogram, Global longitudinal strain, Kidney transplant, Post-transplant events, Speckle-tracking",
author = "Kana Fujikura and Bradley Peltzer and Nidhish Tiwari and Shim, {Hye Gi} and Dinhofer, {Ally B.} and Shitole, {Sanyog G.} and Jorge Kizer and Garcia, {Mario J.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ijcard.2018.07.088",
language = "English (US)",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Reduced global longitudinal strain is associated with increased risk of cardiovascular events or death after kidney transplant

AU - Fujikura, Kana

AU - Peltzer, Bradley

AU - Tiwari, Nidhish

AU - Shim, Hye Gi

AU - Dinhofer, Ally B.

AU - Shitole, Sanyog G.

AU - Kizer, Jorge

AU - Garcia, Mario J.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant. Method: Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant. Medical records were evaluated for demographics and patient characteristics. Echocardiograms were analyzed for conventional measurements, and GLS was assessed using speckle-tracking analysis. Results: The median age of the study sample was 54 years. Overall, 60% were men; 35% were non-Hispanic black, and 50% Hispanic. After a mean follow-up of 3.8 ± 0.5 years, there were 21 cardiovascular events or deaths. Patients who experienced an event were older, more frequently had a history of coronary artery disease, and had higher LV filling/longitudinal diastolic annular velocity (E/e’) than those who did not. GLS was significantly associated with event-free survival even after adjusting for age, sex, race-ethnicity, hypertension, diabetes, history of coronary artery disease or heart failure, and E/e’. Conclusion: Reduced GLS peri-transplant is significantly associated with increased CVD events or death after kidney transplant. Larger studies are required to determine the incremental predictive value of GLS over clinical and other echocardiographic parameters for adverse CVD events following renal transplantation.

AB - Background: Patients with chronic kidney disease are at increased risk of cardiovascular disease (CVD). Even after kidney transplant, the rate of CVD events and death remain elevated. Early detection of patients at risk would be helpful for guiding aggressive preventive therapy. The purpose of this study was to evaluate global longitudinal strain (GLS) as a predictor of CVD events and death after kidney transplant. Method: Among patients with successful kidney transplant between 3/2009 and 12/2012 at our institution, 111 individuals had an echocardiogram within 6 months of the transplant. Medical records were evaluated for demographics and patient characteristics. Echocardiograms were analyzed for conventional measurements, and GLS was assessed using speckle-tracking analysis. Results: The median age of the study sample was 54 years. Overall, 60% were men; 35% were non-Hispanic black, and 50% Hispanic. After a mean follow-up of 3.8 ± 0.5 years, there were 21 cardiovascular events or deaths. Patients who experienced an event were older, more frequently had a history of coronary artery disease, and had higher LV filling/longitudinal diastolic annular velocity (E/e’) than those who did not. GLS was significantly associated with event-free survival even after adjusting for age, sex, race-ethnicity, hypertension, diabetes, history of coronary artery disease or heart failure, and E/e’. Conclusion: Reduced GLS peri-transplant is significantly associated with increased CVD events or death after kidney transplant. Larger studies are required to determine the incremental predictive value of GLS over clinical and other echocardiographic parameters for adverse CVD events following renal transplantation.

KW - Echocardiogram

KW - Global longitudinal strain

KW - Kidney transplant

KW - Post-transplant events

KW - Speckle-tracking

UR - http://www.scopus.com/inward/record.url?scp=85050855738&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050855738&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2018.07.088

DO - 10.1016/j.ijcard.2018.07.088

M3 - Article

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -