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肾移植术后左心室扭转变化

Left ventricular torsion changes post kidney transplantation.

作者信息

Deng Yan, Pandit Anil, Heilman Raymond L, Chakkera Harini A, Mazur Marek J, Mookadam Farouk

机构信息

Department of Cardiovascular Ultrasound and Non-invasive Cardiology, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Sichuan, China.

Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA.

出版信息

J Cardiovasc Ultrasound. 2013 Dec;21(4):171-6. doi: 10.4250/jcu.2013.21.4.171. Epub 2013 Dec 27.

Abstract

BACKGROUND

To quantify changes of left ventricular (LV) torsion in patients' pre and post kidney transplantation.

METHODS

A prospective study was conducted on 48 patients who received kidney transplantation for end stage renal disease and without myocardial infarction. The rotation, twist and torsion of LV were studied pre and post kidney transplantation (6 months post transplantation) using velocity vector imaging by echocardiography. The data is expressed as mean ± standard deviation and compared by paired t-test at the p < 0.05 significance level.

RESULTS

Six months post kidney transplantation, left ventricular ejection fraction (from 40.33 ± 11.42 to 61.00 ± 13.68%), ratio of mitral early and late diastolic filling velocity (from 1.04 ± 0.57 to 1.21 ± 0.52), rotation of basal LV (from 4.48 ± 2.66 to 5.65 ± 2.64 degree), rotation of apical LV (from 4.27 ± 3.08 to 5.50 ± 4.25 degree), LV twist (8.75 ± 4.45 to 11.14 ± 5.25 degree) and torsion (from 1.06 ± 0.54 to 1.33 ± 0.61 degree/cm) were increased significantly (p < 0.05). Interventricular septum thickness (from 11.67 ± 2.39 to 9.67 ± 0.48 mm), left ventricular mass index (from 104.00 ± 16.47 to 95.50 ± 21.44 g/m(2)), systolic blood pressure (from 143.50 ± 34.99 to 121.50 ± 7.09 mmHg), serum blood urea nitrogen (from 42.40 ± 7.98 to 30.43 ± 13.85 mg/dL) and creatinine (from 4.53 ± 1.96 to 2.73 ± 2.57 mg/dL) were decreased significantly (p < 0.05).

CONCLUSION

Kidney transplantation in end stage renal disease without myocardial infarction results in improvement in left ventricular structure, function and myocardial mechanics as detected by echocardiography and velocity vector imaging. Velocity vector imaging provided valuable information for detection and follow-up of cardiac abnormalities in patients with end stage renal disease.

摘要

背景

量化肾移植患者术前及术后左心室(LV)扭转的变化。

方法

对48例因终末期肾病接受肾移植且无心肌梗死的患者进行前瞻性研究。采用超声心动图速度向量成像技术,在肾移植术前及术后(移植后6个月)研究左心室的旋转、扭转及扭矩情况。数据以均值±标准差表示,并在p<0.05显著性水平下采用配对t检验进行比较。

结果

肾移植术后6个月,左心室射血分数(从40.33±11.42增至61.00±13.68%)、二尖瓣舒张早期与晚期充盈速度比值(从1.04±0.57增至1.21±0.52)、左心室基底段旋转(从4.48±2.66度增至5.65±2.64度)、左心室心尖段旋转(从4.27±3.08度增至5.50±4.25度)、左心室扭转(从8.75±4.45度增至11.14±5.25度)及扭矩(从1.06±0.54增至1.33±0.61度/cm)均显著增加(p<0.05)。室间隔厚度(从11.67±2.39降至9.67±0.48mm)、左心室质量指数(从104.00±16.47降至95.50±21.44g/m²)、收缩压(从143.50±34.99降至121.50±7.09mmHg)、血清尿素氮(从42.40±7.98降至30.43±13.85mg/dL)及肌酐(从4.53±1.96降至2.73±2.57mg/dL)均显著降低(p<0.05)。

结论

无心肌梗死的终末期肾病患者肾移植后,经超声心动图和速度向量成像检测显示左心室结构、功能及心肌力学得到改善。速度向量成像为终末期肾病患者心脏异常的检测及随访提供了有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/837a/3894368/f8bf4ff6cd0e/jcu-21-171-g001.jpg

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