Changes in global longitudinal strain in renal transplant recipients following 12 months of exercise

Introduction: Prolonged sedentarism and potential cardiotoxicity for multiple drug’s therapy expose Renal Transplant Recipients (RTR) to an high risk of cardiovascular events. Physical exercise is often suggested to contrast the negative impact of the multiple comorblities. 2D Speckle Tracking Strain (STS) analysis is now largely proposed to early detect the eventual myocardial damage. The study aims to evaluate the changes in global longitudinal strain (GLS), before and after participation in a home based exercise training program in RTR. Methods: A group of 30 RTR (12 females and 18 males, aged 47.9 ± 12.3 y)were submitted to individualized aerobic and static exercise programs for at least 12 months. The exercise prescription was graded by the cycle ergometer test, hand grip dynamometry, with the goal of achieving 150 minutes*wk-1 of activity at moderate intensity. They were followed by a complete 2D echo examination including strain analysis at T0, T6, and T12 months. Repeated measure ANOVA and a two-way mixed ANOVA with Tukey post-hoc analysis and Bonferroni correction was used to detect differences across time differences. Results: GLS significantly at T6, and maintain high at T12 from baseline (GLS: -17.9 ± 3.3 vs -20.4 ± 3.2 and -20.5 ± 3.8 ). No changes in ejection fraction over time. Conclusions: More than EF, 2D ST appears sensible in detecting training adaptations, and myocardial performance improvement, especially at the onset of moderately intense exercise program. Studies should investigate the role of the GLS in the management of exercise intensity to improve cardiac function despite unsupervised.