Long-Term structural and functional myocardial adaptations in healthy living kidney donors

A pilot study

Diego Bellavia, Alessandro Cataliotti, Francesco Clemenza, Cesar Hernandez Baravoglia, Angelo Luca, Marcello Traina, Bruno Gridelli, Tullio Bertani, John C. Burnett, Cesare Scardulla

Research output: Contribution to journalArticle

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Abstract

Background and Aims Compensatory renal hypertrophy following unilateral nephrectomy (UNX) occurs in the remaining kidney. However, the long-Term cardiac adaptive process to UNX remains poorly defined in humans. Our goal was to characterize myocardial structure and function in living kidney donors (LKDs), approximately 12 years after UNX. Methods and Results Cardiac function and structure in 15 Italian LKDs, at least 5 years after UNX (median time from donation = 8.4 years) was investigated and compared to those of age and sex matched U.S. citizens healthy controls (n = 15). Standard and speckle tracking echocardiography (STE) was performed in both LKDs and controls. Plasma angiotensin II, aldosterone, atrial natriuretic peptide (ANP), N terminus pro B-Type natriuretic peptide (NT-proBNP), cyclic guanylyl monophosphate (cGMP), and amino-Terminal peptide of procollagen III (PIIINP) were also collected. Median follow-up was 11.9 years. In LKDs, LV geometry and function by STE were similar to controls, wall thickness and volumes were within normal limits also by CMR. In LKDs, CMR was negative for myocardial fibrosis, but apical rotation and LV torsion obtained by STE were impaired as compared to controls (21.4 ± 7.8 vs 32.7 ± 8.9 degrees, p = 0.04). Serum creatinine and PIIINP levels were increased [1.1 (0.9-1.3) mg/ dL, and 5.8 (5.4-7.6)] μg/L, respectively), while urinary cGMP was reduced [270 (250-355) vs 581 (437-698) pmol/mL] in LKDs. No LKD developed cardiovascular or renal events during follow-up. Conclusions Long-Term kidney donors have no apparent structural myocardial abnormalities as assessed by contrast enhanced CMR. However, myocardial deformation of the apical segments, as well as apical rotation, and LV torsion are reduced. The concomitant increase in circulating PIIINP level is suggestive of fibrosis. Further studies, focused on US and EU patients are warranted to evaluate whether these early functional modifications will progress to a more compromised cardiac function and structure at a later time.

Original languageEnglish
Article numbere0142103
JournalPLoS One
Volume10
Issue number11
DOIs
Publication statusPublished - Nov 10 2015

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Living Donors
Echocardiography
Speckle
kidneys
Kidney
Torsional stress
echocardiography
Brain Natriuretic Peptide
Atrial Natriuretic Factor
Aldosterone
Angiotensin II
Creatinine
cardiac output
fibrosis
Plasmas
Geometry
Fibrosis
procollagen Type III-N-terminal peptide
natriuretic peptides
atrial natriuretic peptide

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Long-Term structural and functional myocardial adaptations in healthy living kidney donors : A pilot study. / Bellavia, Diego; Cataliotti, Alessandro; Clemenza, Francesco; Baravoglia, Cesar Hernandez; Luca, Angelo; Traina, Marcello; Gridelli, Bruno; Bertani, Tullio; Burnett, John C.; Scardulla, Cesare.

In: PLoS One, Vol. 10, No. 11, e0142103, 10.11.2015.

Research output: Contribution to journalArticle

Bellavia, D, Cataliotti, A, Clemenza, F, Baravoglia, CH, Luca, A, Traina, M, Gridelli, B, Bertani, T, Burnett, JC & Scardulla, C 2015, 'Long-Term structural and functional myocardial adaptations in healthy living kidney donors: A pilot study', PLoS One, vol. 10, no. 11, e0142103. https://doi.org/10.1371/journal.pone.0142103
Bellavia, Diego ; Cataliotti, Alessandro ; Clemenza, Francesco ; Baravoglia, Cesar Hernandez ; Luca, Angelo ; Traina, Marcello ; Gridelli, Bruno ; Bertani, Tullio ; Burnett, John C. ; Scardulla, Cesare. / Long-Term structural and functional myocardial adaptations in healthy living kidney donors : A pilot study. In: PLoS One. 2015 ; Vol. 10, No. 11.
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abstract = "Background and Aims Compensatory renal hypertrophy following unilateral nephrectomy (UNX) occurs in the remaining kidney. However, the long-Term cardiac adaptive process to UNX remains poorly defined in humans. Our goal was to characterize myocardial structure and function in living kidney donors (LKDs), approximately 12 years after UNX. Methods and Results Cardiac function and structure in 15 Italian LKDs, at least 5 years after UNX (median time from donation = 8.4 years) was investigated and compared to those of age and sex matched U.S. citizens healthy controls (n = 15). Standard and speckle tracking echocardiography (STE) was performed in both LKDs and controls. Plasma angiotensin II, aldosterone, atrial natriuretic peptide (ANP), N terminus pro B-Type natriuretic peptide (NT-proBNP), cyclic guanylyl monophosphate (cGMP), and amino-Terminal peptide of procollagen III (PIIINP) were also collected. Median follow-up was 11.9 years. In LKDs, LV geometry and function by STE were similar to controls, wall thickness and volumes were within normal limits also by CMR. In LKDs, CMR was negative for myocardial fibrosis, but apical rotation and LV torsion obtained by STE were impaired as compared to controls (21.4 ± 7.8 vs 32.7 ± 8.9 degrees, p = 0.04). Serum creatinine and PIIINP levels were increased [1.1 (0.9-1.3) mg/ dL, and 5.8 (5.4-7.6)] μg/L, respectively), while urinary cGMP was reduced [270 (250-355) vs 581 (437-698) pmol/mL] in LKDs. No LKD developed cardiovascular or renal events during follow-up. Conclusions Long-Term kidney donors have no apparent structural myocardial abnormalities as assessed by contrast enhanced CMR. However, myocardial deformation of the apical segments, as well as apical rotation, and LV torsion are reduced. The concomitant increase in circulating PIIINP level is suggestive of fibrosis. Further studies, focused on US and EU patients are warranted to evaluate whether these early functional modifications will progress to a more compromised cardiac function and structure at a later time.",
author = "Diego Bellavia and Alessandro Cataliotti and Francesco Clemenza and Baravoglia, {Cesar Hernandez} and Angelo Luca and Marcello Traina and Bruno Gridelli and Tullio Bertani and Burnett, {John C.} and Cesare Scardulla",
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T1 - Long-Term structural and functional myocardial adaptations in healthy living kidney donors

T2 - A pilot study

AU - Bellavia, Diego

AU - Cataliotti, Alessandro

AU - Clemenza, Francesco

AU - Baravoglia, Cesar Hernandez

AU - Luca, Angelo

AU - Traina, Marcello

AU - Gridelli, Bruno

AU - Bertani, Tullio

AU - Burnett, John C.

AU - Scardulla, Cesare

PY - 2015/11/10

Y1 - 2015/11/10

N2 - Background and Aims Compensatory renal hypertrophy following unilateral nephrectomy (UNX) occurs in the remaining kidney. However, the long-Term cardiac adaptive process to UNX remains poorly defined in humans. Our goal was to characterize myocardial structure and function in living kidney donors (LKDs), approximately 12 years after UNX. Methods and Results Cardiac function and structure in 15 Italian LKDs, at least 5 years after UNX (median time from donation = 8.4 years) was investigated and compared to those of age and sex matched U.S. citizens healthy controls (n = 15). Standard and speckle tracking echocardiography (STE) was performed in both LKDs and controls. Plasma angiotensin II, aldosterone, atrial natriuretic peptide (ANP), N terminus pro B-Type natriuretic peptide (NT-proBNP), cyclic guanylyl monophosphate (cGMP), and amino-Terminal peptide of procollagen III (PIIINP) were also collected. Median follow-up was 11.9 years. In LKDs, LV geometry and function by STE were similar to controls, wall thickness and volumes were within normal limits also by CMR. In LKDs, CMR was negative for myocardial fibrosis, but apical rotation and LV torsion obtained by STE were impaired as compared to controls (21.4 ± 7.8 vs 32.7 ± 8.9 degrees, p = 0.04). Serum creatinine and PIIINP levels were increased [1.1 (0.9-1.3) mg/ dL, and 5.8 (5.4-7.6)] μg/L, respectively), while urinary cGMP was reduced [270 (250-355) vs 581 (437-698) pmol/mL] in LKDs. No LKD developed cardiovascular or renal events during follow-up. Conclusions Long-Term kidney donors have no apparent structural myocardial abnormalities as assessed by contrast enhanced CMR. However, myocardial deformation of the apical segments, as well as apical rotation, and LV torsion are reduced. The concomitant increase in circulating PIIINP level is suggestive of fibrosis. Further studies, focused on US and EU patients are warranted to evaluate whether these early functional modifications will progress to a more compromised cardiac function and structure at a later time.

AB - Background and Aims Compensatory renal hypertrophy following unilateral nephrectomy (UNX) occurs in the remaining kidney. However, the long-Term cardiac adaptive process to UNX remains poorly defined in humans. Our goal was to characterize myocardial structure and function in living kidney donors (LKDs), approximately 12 years after UNX. Methods and Results Cardiac function and structure in 15 Italian LKDs, at least 5 years after UNX (median time from donation = 8.4 years) was investigated and compared to those of age and sex matched U.S. citizens healthy controls (n = 15). Standard and speckle tracking echocardiography (STE) was performed in both LKDs and controls. Plasma angiotensin II, aldosterone, atrial natriuretic peptide (ANP), N terminus pro B-Type natriuretic peptide (NT-proBNP), cyclic guanylyl monophosphate (cGMP), and amino-Terminal peptide of procollagen III (PIIINP) were also collected. Median follow-up was 11.9 years. In LKDs, LV geometry and function by STE were similar to controls, wall thickness and volumes were within normal limits also by CMR. In LKDs, CMR was negative for myocardial fibrosis, but apical rotation and LV torsion obtained by STE were impaired as compared to controls (21.4 ± 7.8 vs 32.7 ± 8.9 degrees, p = 0.04). Serum creatinine and PIIINP levels were increased [1.1 (0.9-1.3) mg/ dL, and 5.8 (5.4-7.6)] μg/L, respectively), while urinary cGMP was reduced [270 (250-355) vs 581 (437-698) pmol/mL] in LKDs. No LKD developed cardiovascular or renal events during follow-up. Conclusions Long-Term kidney donors have no apparent structural myocardial abnormalities as assessed by contrast enhanced CMR. However, myocardial deformation of the apical segments, as well as apical rotation, and LV torsion are reduced. The concomitant increase in circulating PIIINP level is suggestive of fibrosis. Further studies, focused on US and EU patients are warranted to evaluate whether these early functional modifications will progress to a more compromised cardiac function and structure at a later time.

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