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Autores principales: Zalan Shah, Ava Delonais‐Parker, Yanqing Lyu, Spencer Hobbs, Sophia Heuer, Rushda Faruk Mansuri, Krista L. Lentine, Mina M. Benjamin
Formato: Artículo Open Access
Publicado: Wiley 2026
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Acceso en línea:https://onlinelibrary.wiley.com/doi/10.1111/echo.70457
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author Zalan Shah
Ava Delonais‐Parker
Yanqing Lyu
Spencer Hobbs
Sophia Heuer
Rushda Faruk Mansuri
Krista L. Lentine
Mina M. Benjamin
author_facet Zalan Shah
Ava Delonais‐Parker
Yanqing Lyu
Spencer Hobbs
Sophia Heuer
Rushda Faruk Mansuri
Krista L. Lentine
Mina M. Benjamin
Zalan Shah
Ava Delonais‐Parker
Yanqing Lyu
Spencer Hobbs
Sophia Heuer
Rushda Faruk Mansuri
Krista L. Lentine
Mina M. Benjamin
collection Wiley Open Access
contents Association of Pre‐Transplant Left Ventricular Longitudinal Strain With Long‐Term Cardiovascular Outcomes Following Kidney Transplantation Zalan Shah Ava Delonais‐Parker Yanqing Lyu Spencer Hobbs Sophia Heuer Rushda Faruk Mansuri Krista L. Lentine Mina M. Benjamin Echocardiography ABSTRACT Purpose Cardiovascular disease (CVD) remains the leading cause of death among kidney transplant recipients (KTRs). Current guidelines recommend using left ventricular global longitudinal strain (GLS) for the early identification of cardiac dysfunction, but its value in KTRs has not been well studied. Methods We performed a single‐center retrospective cohort study of adult KTRs who underwent KT between January 2015 and January 2024 and had an adequate‐quality pre‐transplant echocardiogram. Patients without follow‐up at our institution or with atrial fibrillation were excluded. GLS was measured using vendor‐independent two‐dimensional speckle‐tracking software, with abnormal GLS defined as absolute GLS < 16% (lower absolute strain magnitude), with higher values indicating better systolic function. Patients were divided into normal GLS (NGLS) or abnormal GLS (AbGLS) groups. The primary outcome was major adverse cardiovascular events (MACE), defined as cardiovascular death, acute coronary syndrome, stroke, hospitalization for heart failure, or major arrhythmia. Kaplan–Meier survival curves and Cox proportional hazards models were constructed for statistical analysis. Results Of 518 screened KTRs, 341 met the study criteria. Compared with NGLS patients ( n = 159), AbGLS patients ( n = 182) were older (55.1 vs. 51.5 years) and had a significantly higher prevalence of hypertension, diabetes mellitus, and coronary artery disease. Over a mean follow‐up of 52.7 ± 28.3 months, Kaplan–Meier analysis demonstrated a significantly higher cumulative incidence of MACE in the AbGLS group, with a 5‐year incidence of 27.1% versus 9.4% in NGLS (log‐rank p = 0.002). In multivariable Cox regression adjusted for confounding variables identified from univariate regression, GLS was independently associated with MACE (adjusted HR 0.94; 95% CI 0.88–1.00; p = 0.04), whereas left ventricular ejection fraction was not. Conclusion In this retrospective single‐center study, GLS was independently associated with MACE in KTRs, supporting a potential role for GLS in cardiovascular risk assessment in KT candidates. 10.1111/echo.70457 http://onlinelibrary.wiley.com/termsAndConditions#vor
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spellingShingle Association of Pre‐Transplant Left Ventricular Longitudinal Strain With Long‐Term Cardiovascular Outcomes Following Kidney Transplantation
Zalan Shah
Ava Delonais‐Parker
Yanqing Lyu
Spencer Hobbs
Sophia Heuer
Rushda Faruk Mansuri
Krista L. Lentine
Mina M. Benjamin
Echocardiography
Association of Pre‐Transplant Left Ventricular Longitudinal Strain With Long‐Term Cardiovascular Outcomes Following Kidney Transplantation Zalan Shah Ava Delonais‐Parker Yanqing Lyu Spencer Hobbs Sophia Heuer Rushda Faruk Mansuri Krista L. Lentine Mina M. Benjamin Echocardiography ABSTRACT Purpose Cardiovascular disease (CVD) remains the leading cause of death among kidney transplant recipients (KTRs). Current guidelines recommend using left ventricular global longitudinal strain (GLS) for the early identification of cardiac dysfunction, but its value in KTRs has not been well studied. Methods We performed a single‐center retrospective cohort study of adult KTRs who underwent KT between January 2015 and January 2024 and had an adequate‐quality pre‐transplant echocardiogram. Patients without follow‐up at our institution or with atrial fibrillation were excluded. GLS was measured using vendor‐independent two‐dimensional speckle‐tracking software, with abnormal GLS defined as absolute GLS < 16% (lower absolute strain magnitude), with higher values indicating better systolic function. Patients were divided into normal GLS (NGLS) or abnormal GLS (AbGLS) groups. The primary outcome was major adverse cardiovascular events (MACE), defined as cardiovascular death, acute coronary syndrome, stroke, hospitalization for heart failure, or major arrhythmia. Kaplan–Meier survival curves and Cox proportional hazards models were constructed for statistical analysis. Results Of 518 screened KTRs, 341 met the study criteria. Compared with NGLS patients ( n = 159), AbGLS patients ( n = 182) were older (55.1 vs. 51.5 years) and had a significantly higher prevalence of hypertension, diabetes mellitus, and coronary artery disease. Over a mean follow‐up of 52.7 ± 28.3 months, Kaplan–Meier analysis demonstrated a significantly higher cumulative incidence of MACE in the AbGLS group, with a 5‐year incidence of 27.1% versus 9.4% in NGLS (log‐rank p = 0.002). In multivariable Cox regression adjusted for confounding variables identified from univariate regression, GLS was independently associated with MACE (adjusted HR 0.94; 95% CI 0.88–1.00; p = 0.04), whereas left ventricular ejection fraction was not. Conclusion In this retrospective single‐center study, GLS was independently associated with MACE in KTRs, supporting a potential role for GLS in cardiovascular risk assessment in KT candidates. 10.1111/echo.70457 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Association of Pre‐Transplant Left Ventricular Longitudinal Strain With Long‐Term Cardiovascular Outcomes Following Kidney Transplantation
topic Echocardiography
url https://onlinelibrary.wiley.com/doi/10.1111/echo.70457