■终末期肾病(ESRD)患者容易发生心脏血流动力学改变,特别是左心室(LV)和左心房(LA)功能通常是由于尿毒症等因素,流体过载,和炎症。虽然存在关于ESRD中LV功能的研究,对LA功能的研究是有限的。成功的肾移植(KTx)被认为可以逆转病理性心脏重建,监测移植前后心脏劳损的变化可指导移植前后的护理。这项研究有两个主要目的:调查KTx后LA和LV应变和其他超声心动图参数的变化,并确定预测KTx后应变参数受损的独立因素。
■我们对49例接受KTx的ESRD患者进行了前瞻性队列研究。在基线和KTx后3个月进行超声心动图检查。左心室舒张末期容积,左心室收缩末期容积,左心室舒张末期内径,左心室射血分数(LVEF),E/E\',最大LA体积指数(LAVi),低压全球纵向应变(LVGLS),和所有LA应变值,包括助推器(LASb),导管(LAScd),和水库(LASr),KTx治疗后明显改善(P<0.05)。关于受损LA和LV菌株的独立预测因子,LVEF的前KTx值,拉维,和NT-proBNP与KTx后的LVGLS损伤相关;LAVi和LVEF的前KTx值与KTx后的LASr损伤相关。
■本研究提供了有价值的证据,证明了KTx对尿毒症性心肌病的影响,并通过LA菌株和LV菌株的改善证明了KTx前LVEF和LAVi是KTx后LVGLS和LASr受损的重要独立预测因子。
UNASSIGNED: End-stage renal disease (ESRD) patients are prone to alterations in cardiac haemodynamics specifically on the left ventricle (LV) and left atrial (LA) functions usually due to factors like uraemia, fluid overload, and inflammation. While studies on LV function in ESRD exist, research on LA function is limited. Successful kidney transplant (KTx) is believed to reverse pathological cardiac remodelling, and monitoring changes in cardiac strain before and after transplantation may guide pre- and post-transplant care. This study has two main objectives: to investigate alterations in LA and LV strain and other echocardiographic parameters after KTx and to identify independent factors predicting impaired strain parameters post-KTx.
UNASSIGNED: We conducted a prospective cohort study of 49 ESRD patients who underwent KTx. Echocardiography was performed at baseline and at 3 months after KTx. LV end-diastolic volume, LV end-systolic volume, LV end-diastolic diameter, LV ejection fraction (LVEF), E/e\', maximum LA volume index (LAVi), LV global longitudinal strain (LVGLS), and all LA strain values, including booster (LASb), conduit (LAScd), and reservoir (LASr), improved significantly after KTx (P < 0.05). Regarding independent predictors of impaired LA and LV strains, pre-KTx values of LVEF, LAVi, and NT-proBNP were associated with LVGLS impairment after KTx; pre-KTx values of LAVi and LVEF were associated with LASr impairment after KTx.
UNASSIGNED: The present study provided valuable evidence on the effects of KTx on uraemic cardiomyopathy demonstrated by LA strain and LV strain improvements and indicated pre-KTx LVEF and LAVi as significant independent predictors of LVGLS and LASr impairment after KTx.