Le Qin1, Shengjia Gu1, Ruijie Xiao1, Peng Liu1, Fuhua Yan1, Haijin Yu2, Wenjie Yang3. 1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, China. 2. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, China. yhj10913@rjh.com.cn. 3. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai, 200025, China. lisa_ywj@163.com.
Abstract
OBJECTIVES: This study aimed to evaluate the association of myocardial characterization by native T1 mapping using cardiac MR (CMR) with the incidence of major adverse cardiovascular event (MACE) in end-stage renal dysfunction (ESRD) patients on hemodialysis. METHODS: A total of 52 ESRD patients and 52 healthy individuals were prospectively recruited between June 2017 and June 2018. ESRD patients underwent CMR examinations post-hemodialysis for the evaluation of cardiac function and global native T1 mapping. Demographics, serum biomarkers, and coronary artery calcification were collected. MACE including all-caused death, and new onset of myocardial infarction, heart failure leading to hospitalization, fatal arrhythmia, and cardiac arrest was set as the endpoint. RESULTS: During a median follow-up of 38.0 months, 13 patients (25.0%) reached the endpoints. Global native T1 mapping in patients on hemodialysis was significantly higher compared with that of healthy individuals (1280.3 ms ± 45.3 vs. 1238.2 ms ± 31.1, p < 0.001). In the univariate Cox regression analysis, global native T1 mapping (HR [hazard ratios]: 1.887, 95% CI [confidence interval]: 1.302-2.736, p = 0.001) was associated with the prediction of MACE. Multivariate Cox regression analysis demonstrated that global native T1 mapping (HR: 1.580, 95% CI: 1.112-2.244, p = 0.011) and age (HR: 1.088, 95% CI: 1.032-1.146, p = 0.002) were associated with the incidence of MACE after adjusting for other conventional risk factors. CONCLUSIONS: Global native T1 mapping by CMR can potentially become a novel predictor of MACE in ESRD patients on hemodialysis, providing additional prognostic values over conventional risk factors. However, this conclusion should be validated in a larger sample size of hemodialysis patients. KEY POINTS: • Global native T1 mapping was significantly higher in ESRD patients on hemodialysis compared with that of normal controls. • Global native T1 mapping was associated with myocardial enzymes, myocardial hypertrophy, coronary calcification, and cardiac function. • Global native T1 mapping value was independently predictive of MACE in hemodialysis patients, providing additional prognostic values over conventional risk factors.
OBJECTIVES: This study aimed to evaluate the association of myocardial characterization by native T1 mapping using cardiac MR (CMR) with the incidence of major adverse cardiovascular event (MACE) in end-stage renal dysfunction (ESRD) patients on hemodialysis. METHODS: A total of 52 ESRD patients and 52 healthy individuals were prospectively recruited between June 2017 and June 2018. ESRD patients underwent CMR examinations post-hemodialysis for the evaluation of cardiac function and global native T1 mapping. Demographics, serum biomarkers, and coronary artery calcification were collected. MACE including all-caused death, and new onset of myocardial infarction, heart failure leading to hospitalization, fatal arrhythmia, and cardiac arrest was set as the endpoint. RESULTS: During a median follow-up of 38.0 months, 13 patients (25.0%) reached the endpoints. Global native T1 mapping in patients on hemodialysis was significantly higher compared with that of healthy individuals (1280.3 ms ± 45.3 vs. 1238.2 ms ± 31.1, p < 0.001). In the univariate Cox regression analysis, global native T1 mapping (HR [hazard ratios]: 1.887, 95% CI [confidence interval]: 1.302-2.736, p = 0.001) was associated with the prediction of MACE. Multivariate Cox regression analysis demonstrated that global native T1 mapping (HR: 1.580, 95% CI: 1.112-2.244, p = 0.011) and age (HR: 1.088, 95% CI: 1.032-1.146, p = 0.002) were associated with the incidence of MACE after adjusting for other conventional risk factors. CONCLUSIONS: Global native T1 mapping by CMR can potentially become a novel predictor of MACE in ESRD patients on hemodialysis, providing additional prognostic values over conventional risk factors. However, this conclusion should be validated in a larger sample size of hemodialysis patients. KEY POINTS: • Global native T1 mapping was significantly higher in ESRD patients on hemodialysis compared with that of normal controls. • Global native T1 mapping was associated with myocardial enzymes, myocardial hypertrophy, coronary calcification, and cardiac function. • Global native T1 mapping value was independently predictive of MACE in hemodialysis patients, providing additional prognostic values over conventional risk factors.
Authors: Srisakul Chirakarnjanakorn; Sankar D Navaneethan; Gary S Francis; W H Wilson Tang Journal: Int J Cardiol Date: 2017-01-04 Impact factor: 4.164
Authors: Peter A McCullough; Christopher T Chan; Eric D Weinhandl; John M Burkart; George L Bakris Journal: Am J Kidney Dis Date: 2016-11 Impact factor: 8.860
Authors: Thaminda Liyanage; Toshiharu Ninomiya; Vivekanand Jha; Bruce Neal; Halle Marie Patrice; Ikechi Okpechi; Ming-hui Zhao; Jicheng Lv; Amit X Garg; John Knight; Anthony Rodgers; Martin Gallagher; Sradha Kotwal; Alan Cass; Vlado Perkovic Journal: Lancet Date: 2015-03-13 Impact factor: 79.321
Authors: Stefan D Anker; Iain A Gillespie; Kai-Uwe Eckardt; Florian Kronenberg; Sharon Richards; Tilman B Drueke; Peter Stenvinkel; Ronald L Pisoni; Bruce M Robinson; Daniele Marcelli; Marc Froissart; Jürgen Floege Journal: Int J Cardiol Date: 2016-04-20 Impact factor: 4.164
Authors: Bruce M Robinson; Tadao Akizawa; Kitty J Jager; Peter G Kerr; Rajiv Saran; Ronald L Pisoni Journal: Lancet Date: 2016-05-22 Impact factor: 79.321
Authors: Felix Poppelaars; Bernardo Faria; Mariana Gaya da Costa; Casper F M Franssen; Willem J van Son; Stefan P Berger; Mohamed R Daha; Marc A Seelen Journal: Front Immunol Date: 2018-01-25 Impact factor: 7.561
Authors: M P M Graham-Brown; A S Patel; D J Stensel; D S March; A-M Marsh; J McAdam; G P McCann; J O Burton Journal: Biomed Res Int Date: 2017-03-02 Impact factor: 3.411