Defining Myocardial Abnormalities Across the Stages of Chronic Kidney Disease: A Cardiac Magnetic Resonance Imaging Study

A proof of concept cross-sectional study investigating changes in myocardial abnormalities across stages of chronic kidney disease (CKD). Characterizing noninvasive markers of myocardial fibrosis on cardiac magnetic resonance, echocardiography, and correlating with biomarkers of fibrosis, myocardial...

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Published in:JACC. Cardiovascular imaging 2020-11, Vol.13 (11), p.2357-2367
Main Authors: Hayer, Manvir K, Radhakrishnan, Ashwin, Price, Anna M, Liu, Boyang, Baig, Shanat, Weston, Christopher J, Biasiolli, Luca, Ferro, Charles J, Townend, Jonathan N, Steeds, Richard P, Edwards, Nicola C
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Language:English
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Summary:A proof of concept cross-sectional study investigating changes in myocardial abnormalities across stages of chronic kidney disease (CKD). Characterizing noninvasive markers of myocardial fibrosis on cardiac magnetic resonance, echocardiography, and correlating with biomarkers of fibrosis, myocardial injury, and functional correlates including exercise tolerance. CKD is associated with an increased risk of cardiovascular death. Much of the excess mortality is attributed to uremic cardiomyopathy, defined by increased left ventricular hypertrophy, myocardial dysfunction, and fibrosis. The prevalence of these abnormalities across stages of CKD and their impact on cardiovascular performance is unknown. A total of 134 nondiabetic, pre-dialysis subjects with CKD stages 2 to 5 without myocardial ischemia underwent cardiac magnetic resonance (1.5-T) including; T mapping (biomarker of diffuse fibrosis), T mapping (edema), late gadolinium enhancement, and assessment of aortic distensibility. Serum biomarkers including collagen turnover (P1NP, P3NP), troponin T, and N-terminal pro-B-type natriuretic peptide were measured. Cardiovascular performance was quantified by bicycle cardiopulmonary exercise testing and echocardiography. Native myocardial T times increased incrementally from stage 2 to 5 (966 ± 21 ms vs. 994 ± 33 ms; p 
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2020.04.021