Luca Arcari1, Rocio Hinojar2, Juergen Engel3, Tilo Freiwald3, Steffen Platschek3, Hafisyatul Zainal4, Hui Zhou5, Moises Vasquez6, Till Keller7, Andreas Rolf7, Helmut Geiger3, Ingeborg Hauser3, Thomas J Vogl8, Andreas M Zeiher8, Massimo Volpe9, Eike Nagel10, Valentina O Puntmann11. 1. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Cardiology Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy. 2. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Cardiology, University Hospital Ramón y Cajal, Madrid, Spain. 3. Department of Nephrology, Goethe University Hospital Frankfurt, Frankfuret-am Main, Germany. 4. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Cardiology, Universiti Teknologi MARA (UiTM), Sg. Buloh, Malaysia. 5. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Radiology, XiangYa Hospital, Central South University, Changsha, Hunan, China. 6. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Cardiology, Enrique Baltodano Briceño Hospital, Liberia, Costa Rica. 7. Department of Cardiology, Kerckhoff Hospital, University Giessen, Bad Nauheim, Germany. 8. Department of Radiology, Goethe University Hospital Frankfurt, Frankfurt-am Main, Germany. 9. Cardiology Unit, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy. 10. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany. 11. Institute of Experimental and Translational Cardiac Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany; Department of Cardiology, Goethe University Hospital Frankfurt, Frankfurt-am Main, Germany. Electronic address: vppapers@icloud.com.
Abstract
AIMS: Profound left ventricular (LV) hypertrophy with diastolic dysfunction and heart failure is the cardinal manifestation of heart remodelling in chronic kidney disease (CKD). Previous studies related increased T1 mapping values in CKD with diffuse fibrosis. Native T1 is a non-specific readout that may also relate to increased intramyocardial fluid. We examined concomitant T1 and T2 mapping signatures and undertook comparisons with other hypertrophic conditions. METHODS: In this prospective multicentre study, consecutive CKD patients (n = 154) undergoing routine clinical cardiac magnetic resonance (CMR) imaging were compared with patients with hypertensive (HTN, n = 163) and hypertrophic cardiomyopathy (HCM, n = 158), and normotensive controls (n = 133). RESULTS: Native T1 was significantly higher in all patient groups, whereas native T2 in CKD only (p < 0.001 vs. all groups). Native T1 and T2 were interrelated in patient groups and the strength of association was condition-specific (CKD r = 0.558, HTN r = 0.324, both p < 0.001; HCM r = 0.157, p = 0.05). Native T1 and T2 were similarly correlated in all CKD stages (S3 r = 0.501, S4 0.586, S5 r = 0.424, p < 0.001 for all). Native T1 was the strongest myocardial discriminator between patients and controls (area under the curve, AUC HCM: 0.97; CKD: 0.97, HTN 0.98), native T2 between CKD vs HCM (AUC 0.90) and native T1 and T2 between CKD vs HTN (AUC: 0.83 and 0.80 respectively), p < 0.001 for all. CONCLUSIONS: Our findings reveal different CMR signatures of common hypertrophic cardiac phenotypes. Native T1 was raised in all conditions, indicating the presence of pathologic hypertrophic remodelling. Markedly raised native T2 was CKD-specific, suggesting a prominent role of intramyocardial fluid.
AIMS: Profound left ventricular (LV) hypertrophy with diastolic dysfunction and heart failure is the cardinal manifestation of heart remodelling in chronic kidney disease (CKD). Previous studies related increased T1 mapping values in CKD with diffuse fibrosis. Native T1 is a non-specific readout that may also relate to increased intramyocardial fluid. We examined concomitant T1 and T2 mapping signatures and undertook comparisons with other hypertrophic conditions. METHODS: In this prospective multicentre study, consecutive CKD patients (n = 154) undergoing routine clinical cardiac magnetic resonance (CMR) imaging were compared with patients with hypertensive (HTN, n = 163) and hypertrophic cardiomyopathy (HCM, n = 158), and normotensive controls (n = 133). RESULTS: Native T1 was significantly higher in all patient groups, whereas native T2 in CKD only (p < 0.001 vs. all groups). Native T1 and T2 were interrelated in patient groups and the strength of association was condition-specific (CKD r = 0.558, HTN r = 0.324, both p < 0.001; HCM r = 0.157, p = 0.05). Native T1 and T2 were similarly correlated in all CKD stages (S3 r = 0.501, S4 0.586, S5 r = 0.424, p < 0.001 for all). Native T1 was the strongest myocardial discriminator between patients and controls (area under the curve, AUC HCM: 0.97; CKD: 0.97, HTN 0.98), native T2 between CKD vs HCM (AUC 0.90) and native T1 and T2 between CKD vs HTN (AUC: 0.83 and 0.80 respectively), p < 0.001 for all. CONCLUSIONS: Our findings reveal different CMR signatures of common hypertrophic cardiac phenotypes. Native T1 was raised in all conditions, indicating the presence of pathologic hypertrophic remodelling. Markedly raised native T2 was CKD-specific, suggesting a prominent role of intramyocardial fluid.
Authors: Aaron T O'Brien; Katarzyna E Gil; Juliet Varghese; Orlando P Simonetti; Karolina M Zareba Journal: J Cardiovasc Magn Reson Date: 2022-06-06 Impact factor: 6.903
Authors: Andrea Baggiano; Alberico Del Torto; Marco Guglielmo; Giuseppe Muscogiuri; Laura Fusini; Mario Babbaro; Ada Collevecchio; Rocco Mollace; Stefano Scafuri; Saima Mushtaq; Edoardo Conte; Andrea Daniele Annoni; Alberto Formenti; Maria Elisabetta Mancini; Giulia Mostardini; Daniele Andreini; Andrea Igoren Guaricci; Mauro Pepi; Marianna Fontana; Gianluca Pontone Journal: Diagnostics (Basel) Date: 2020-09-29
Authors: Gert J H Snel; Maaike van den Boomen; Katia Hurtado-Ortiz; Riemer H J A Slart; Vincent M van Deursen; Christopher T Nguyen; David E Sosnovik; Rudi A J O Dierckx; Birgitta K Velthuis; Ronald J H Borra; Niek H J Prakken Journal: Front Cardiovasc Med Date: 2022-02-22