Kidney Week

Abstract: SA-PO1069

Relationship Between Cardiorespiratory Fitness and Cardiovascular Structure and Function in Kidney Transplant Recipients

Session Information

• Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ridler, Francesca Eve, University of Leicester Medical School, Leicester, England, United Kingdom

Francesca Eve Ridler

• Billany, Roseanne E., University of Leicester Department of Cardiovascular Sciences, Leicester, England, United Kingdom

Roseanne E. Billany, PhD

• Graham-Brown, Matthew, University of Leicester Department of Cardiovascular Sciences, Leicester, England, United Kingdom

Matthew Graham-Brown, MBChB, PhD

Background

Kidney transplant recipients (KTRs) have a lower life expectancy than the general population, with cardiovascular disease being the leading cause of death. This increased risk is due to a complex combination of traditional and non-traditional risk factors, including low levels of physical activity. Reduced cardiorespiratory fitness has been associated with poor cardiovascular health and mortality in general and CKD populations, but evidence is limited in KTRs. This work explored the association between measures of cardiorespiratory fitness and measures of cardiovascular structure and function in KTRs.

Methods

Baseline data of the ECSERT trial was analysed. The ECSERT trial was a pilot randomised controlled trial of a structured, home-based exercise programme on cardiovascular structure and function in KTRs. We present data for 50 KTRs (>1-year post-transplant, 50±14 years, 23 male) who underwent cardiopulmonary exercise testing (CPET) and cardiac MRI scans. Data are presented for oxygen consumption (VO_{2 peak}, relative O₂ pulse), ventilatory efficiency (VE_peak, VEVO₂ ratio), heart rate recovery, myocardial blood flow, myocardial fibrosis (native T1 times), ventricular function (global circumferential strain) and left ventricular mass. Statistical analysis involved univariate and multivariate linear regression adjusting for age, gender, kidney function and diabetic status.

Results

Significant associations between measures of cardiorespiratory fitness and cardiovascular structure and function were identified. Relative O₂ pulse, VEVO₂ ratio and heart rate recovery at 1-minute after CPET emerged as independent predictors of global myocardial flow during adenosine-induced stress (p=0.040), native T1 times (p=0.030) and global circumferential strain (p=0.015) respectively, which remained significant in the multivariate models. Additionally, VO_{2 peak} (L/min) and VE_peak were associated with left ventricular mass (p=0.008, p<0.001 respectively), and VO_{2 peak} (ml/kg/min) was associated with global myocardial flow during stress (p=0.037).

Conclusion

Poor cardiorespiratory fitness in KTRs associates with pathological changes in cardiac structure and function. Treatment designed to improve cardiorespiratory fitness may improve the burden of cardiovascular disease in this population.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20259yrth3k1