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Novel cardiac nuclear magnetic resonance method for noninvasive assessment of myocardial fibrosis in hemodialysis patients.

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posted on 2016-11-28, 16:45 authored by Matthew P. M. Graham-Brown, Daniel S. March, Darren R. Churchward, D. J. Stensel, Anvesha Singh, Ranjit Arnold, James O. Burton, Gerry P. McCann
Left ventricular hypertrophy and myocardial fibrosis frequently occur in patients with end-stage renal disease receiving hemodialysis therapy and are associated with poor prognosis. Native T1 mapping is a novel cardiac magnetic resonance imaging technique that measures native myocardial T1 relaxation, a surrogate of myocardial fibrosis. Here we compared global and segmental native myocardial T1 time and global longitudinal, circumferential and segmental strain, and cardiac function of 35 hemodialysis patients and 22 control individuals. The median native global T1 time was significantly higher in the hemodialysis than the control group (1270 vs. 1085 ms), with the septal regions of hemodialysis patients having significantly higher median T1 times than nonseptal regions (1293 vs. 1252 ms). The mean peak global circumferential strain and global longitudinal strain were both significantly reduced in hemodialysis patients compared with controls (-18.3 vs. -21.7 and -16.1 vs. -20.4, respectively). Systolic strain was also significantly reduced in the septum compared with the nonseptal myocardium in hemodialysis patients (-16.2 vs. -21.9) but not in control subjects. Global circumferential strain and longitudinal strain significantly correlated with global native T1 values (r = 0.41 and 0.55, respectively), and the septal native T1 significantly correlated with the septal systolic strain (r = 0.46). Thus, myocardial fibrosis may be assessed noninvasively with native T1 mapping; the interventricular septum appears to be particularly prone to the development of fibrosis in hemodialysis patients.

Funding

This study is independent research arising from a Clinician Scientist Award to JB (CS-2013-13-014) supported by the NIHR and an NIHR grant to GM (NIHR-CDF 2014-07-045) and a grant from the Van Geest Foundation. This work is also supported by the NIHR Leicester Cardiovascular Biomedical Research Unit based at University Hospitals of Leicester.

History

Citation

Kidney International, 2016, 90 (4), pp. 835-844

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Infection, Immunity and Inflammation

Version

  • AO (Author's Original)

Published in

Kidney International

Publisher

Elsevier for International Society of Nephrology

issn

0085-2538

eissn

1523-1755

Acceptance date

2016-07-07

Available date

2016-11-28

Publisher version

http://www.sciencedirect.com/science/article/pii/S0085253816303519

Language

en

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