Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal

Rankin, A. J. et al. (2021) Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal. Journal of Cardiovascular Magnetic Resonance, 23, 125. (doi: 10.1186/s12968-021-00822-4) (PMCID:PMC8580743)

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Abstract

Background: Mapping of left ventricular (LV) native T1 is a promising non-invasive, non-contrast imaging biomarker. Native myocardial T1 times are prolonged in patients requiring dialysis, but there are concerns that the dialysis process and fluctuating fluid status may confound results in this population. We aimed to assess the changes in cardiac parameters on 3T cardiovascular magnetic resonance (CMR) before and after haemodialysis, with a specific focus on native T1 mapping. Methods: This is a single centre, prospective observational study in which maintenance haemodialysis patients underwent CMR before and after dialysis (both scans within 24 h). Weight measurement, bio-impedance body composition monitoring, haemodialysis details and fluid intake were recorded. CMR protocol included cine imaging and mapping native T1 and T2. Results: Twenty-six participants (16 male, 65 ± 9 years) were included in the analysis. The median net ultrafiltration volume on dialysis was 2.3 L (IQR 1.8, 2.5), resulting in a median weight reduction at post-dialysis scan of 1.35 kg (IQR 1.0, 1.9), with a median reduction in over-hydration (as measured by bioimpedance) of 0.75 L (IQR 0.5, 1.4). Significant reductions were observed in LV end-diastolic volume (− 25 ml, p = 0.002), LV stroke volume (− 13 ml, p = 0.007), global T1 (21 ms, p = 0.02), global T2 (− 1.2 ms, p = 0.02) following dialysis. There was no change in LV mass (p = 0.35), LV ejection fraction (p = 0.13) or global longitudinal strain (p = 0.22). On linear regression there was no association between baseline over-hydration (as defined by bioimpedance) and global native T1 or global T2, nor was there an association between the change in over-hydration and the change in these parameters. Conclusions: Acute changes in cardiac volumes and myocardial native T1 are detectable on 3T CMR following haemodialysis with fluid removal. The reduction in global T1 suggests that the abnormal native T1 observed in patients on haemodialysis is not entirely due to myocardial fibrosis.

Item Type:Articles
Additional Information:Dr Alastair Rankin is personally funded by a Clinical Academic Training Fellowship from The Chief Scientist Office (Scotland) (CAF/18/02). Dr Elaine Rutherford is supported by a Postdoctoral Clinical Lectureship from The Chief Scientist Office (Scotland) (PCL/18/03). Dr Jennifer Lees is supported by a Postdoctoral Clinical Lectureship from The Chief Scientist Office (Scotland) (PCL/20/10). Thomas Treibel is currently supported by a BHF Intermediate fellowship (FS/19/35/34374). Colin Berry is funded by a British Heart Foundation Centre of Excellence Award (RE/18/6/34217).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Patel, Dr Rajan and Mark, Professor Patrick and Lees, Jennifer and Gillis, Dr Keith and Dymock, Mrs Laura and Roditi, Dr Giles and Rankin, Dr Alastair and Mangion, Dr Kenneth and Rutherford, Dr Elaine and Radjenovic, Dr Aleksandra
Authors: Rankin, A. J., Mangion, K., Lees, J. S., Rutherford, E., Gillis, K. A., Edy, E., Dymock, L., Treibel, T. A., Radjenovic, A., Patel, R. K., Berry, C., Roditi, G., and Mark, P. B.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Cardiovascular Magnetic Resonance
Publisher:BioMed Central
ISSN:1097-6647
ISSN (Online):1532-429X
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Journal of Cardiovascular Magnetic Resonance 23: 125
Publisher Policy:Reproduced under a Creative Commons License

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