The effect of renal transplantation on left ventricular function, electrocardiography, and mechanical synchrony by gated myocardial perfusion imaging

Background Depressed left ventricular ejection fraction (LVEF), LV mechanical dyssynchrony (LVMD), and prolonged QTc interval predict poor outcomes in end-stage renal disease (ESRD). Renal transplantation improves mortality in ESRD patients but the effects of transplantation on these indices remain undefined. Methods We identified patients with myocardial perfusion imaging (MPI) before and after renal transplantation. A control group consisted of ESRD patients who underwent 2 MPIs but did not receive a transplant. Changes in LVEF, LVMD indices [phase standard deviation (SD) and bandwidth (BW)] by MPI, and electrocardiogram (ECG) indices were determined. Results The study population consisted of 32 ESRD patients (53% male, 50 +/- 11 years, 59% African American, 65% diabetic). The second MPI was performed 31 months (13-59 months) after renal transplantation. LVEF (72 +/- 10% vs. 67 +/- 10%, P < 0.001) but not SD (22 +/- 15 degrees vs. 22 +/- 11 degrees, P = 0.9) or BW (58 +/- 35 degrees vs. 57 +/- 29 degrees, P = 0.9) improved after transplantation. There were no changes in these indices in the control group. QTc (425 +/- 30 ms vs. 447 +/- 32 ms, P = <0.001) but not QRS (90 +/- 21 ms vs. 90 +/- 21 ms, P = 0.9) improved significantly after renal transplantation. Conclusions LVEF and QTc improved after renal transplantation but LVMD indices and QRS did not change, which suggests that LVMD and electrical dyssynchrony may be irreversible in ESRD.