Effects of Renal Transplantation on Echocardiographic Changes: Ejection Fraction and Left Ventricular Mass Index

BACKGROUND AND OBJECTIVES: Cardiovascular disease is a leading cause of death in patients on long-term dialysis and cardiac mortality decreases after renal transplantation. The aim of this study was to investigate the effects of successful renal transplantation on cardiac structure and function assessed by echocardiography. MATERIAL AND METHOD: Eighteen adult chronic renal failure patients who were taken renal transplantation in our hospital were included. They were submitted to two echocardiographic evaluations at preoperative time and postoperative time (mean: 23months). RESULTS: At the time of transplantation, 18 patients had undergone hemodialysis through a fistula (mean: 44months). At postoperative follow up, blood urea nitrogen/creatinine were decreased and mean hemoglobin level was increased. And systolic/diastolic blood pressure were decreased. Left ventricular mass index, left ventricular posterior wall thickness and septal wall thickness were decreased and ejection fraction was increased by echocardiography. Diastolic function did not improve. Hemodialysis duration and preoperative blood urea nitrogen/creatinine level affected ejection fraction change. CONCLUSION: We observed significantly decreased left ventricular mass index, increased ejection fraction after renal transplantation. We found that the patients who had been onlonger hemodialysis and higher preoperative blood urea nitrogen/creatinine level showed marked improvement of ejection fraction buy echocardiography.

A Case of Cardiac Metastasis to Left Atrium from Large Cell Carcinoma of the Lung

Metastatic tumors to the heart are far more frequent than primary tumors of the heart. Cardiac metastasis may be detected up to 30 percent of patients with fatal lung cancers. Metastatic cancer to the heart is difficult to suspect. Where cardiac metastasis is diagnosed ante-mortem, signs and symptoms of the primary cancer are usually the presenting features and the presence of cardiac involvement is often incidentally detected. We experienced a case of 35-year-old woman with metastatic lung cancer invading the left atrium via pulmonary vein, which was not proved pathologically. She presented with hemoptysis and chest pain. Transthoracic echocardiography demonstrated massive cardiac infiltration with tumor and decreased cardiac wall motion, correlating with the chest CT findings, which were also remarkable for the presence of intracardiac mass and direct invasion to adherent pericardium, pulmonary vein and left atrium. We suggest that careful examination of 2D echocardiography can be noninvasive and valuable tool for diagnosis of metastatic cancer to the heart.

A Case of Pulmonary Artery Aneurysm with Pulmonary Hypertension

Clinical experiences of pulmonary artery aneurysm are distinctly rare and current knowledge is mainly derived from autopsy findings. Pulmonary artery aneurysms are associated with congenital heart disease, most frequently patient ductus arteriosus, followed in decreasing order by ventricular septal defect, atrial septal defect. In the remaining cases, such aneurysms are associated mainly with secondary acquired lesions, such as Behcet's disease, bacterial endocarditis, syphilis, tuberculosis, atherosclerosis, vasculitis, hypertension, trauma. Angiography was the gold standard for diagnosing pulmonary artery aneurysms, but MRI imaging has been potentially useful diagnostic modality in demonstrating aneurysm and other fine pathologic processes with high resolution. Surgery was main, but there are no firm guidelines for optimal treatment of pulmonary artery aneurysm. We experienced a case of pulmonary artery aneurysm with pulmonary hypertension in a 58 year-old female and observed for 2 years. The aneurysmal size was 5.19 cm initially and inreased to 5.5cm for two years, accompanying by pulmonary hypertension. We report this case of pulmonary artery aneurysm with a brief review of literature.