Cardiac Imaging Biomarkers in Chronic Kidney Disease
Uremic cardiomyopathy (UC), the peculiar cardiac remodeling secondary to the systemic effects of renal dysfunction, is characterized by left ventricular (LV) diffuse fibrosis with hypertrophy (LVH) and stiffness and the development of heart failure and increased rates of cardiovascular mortality. Se...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/13/5/773 |
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| author | Silvia C. Valbuena-López Giovanni Camastra Luca Cacciotti Eike Nagel Valentina O. Puntmann Luca Arcari |
| author_facet | Silvia C. Valbuena-López Giovanni Camastra Luca Cacciotti Eike Nagel Valentina O. Puntmann Luca Arcari |
| author_sort | Silvia C. Valbuena-López |
| collection | DOAJ |
| description | Uremic cardiomyopathy (UC), the peculiar cardiac remodeling secondary to the systemic effects of renal dysfunction, is characterized by left ventricular (LV) diffuse fibrosis with hypertrophy (LVH) and stiffness and the development of heart failure and increased rates of cardiovascular mortality. Several imaging modalities can be used to obtain a non-invasive assessment of UC by different imaging biomarkers, which is the focus of the present review. Echocardiography has been largely employed in recent decades, especially for the determination of LVH by 2-dimensional imaging and diastolic dysfunction by pulsed-wave and tissue Doppler, where it retains a robust prognostic value; more recent techniques include parametric assessment of cardiac deformation by speckle tracking echocardiography and the use of 3D-imaging. Cardiac magnetic resonance (CMR) imaging allows a more accurate assessment of cardiac dimensions, including the right heart, and deformation by feature-tracking imaging; however, the most evident added value of CMR remains tissue characterization. T1 mapping demonstrated diffuse fibrosis in CKD patients, increasing with the worsening of renal disease and evident even in early stages of the disease, with few, but emerging, prognostic data. Some studies using T2 mapping highlighted the presence of subtle, diffuse myocardial edema. Finally, computed tomography, though rarely used to specifically assess UC, might provide incidental findings carrying prognostic relevance, including information on cardiac and vascular calcification. In summary, non-invasive cardiovascular imaging provides a wealth of imaging biomarkers for the characterization and risk-stratification of UC; integrating results from different imaging techniques can aid a better understanding of the physiopathology of UC and improve the clinical management of patients with CKD. |
| first_indexed | 2024-03-11T03:54:32Z |
| format | Article |
| id | doaj.art-37f7764234cb497791bd6c40005efbcd |
| institution | Directory Open Access Journal |
| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-11T03:54:32Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj.art-37f7764234cb497791bd6c40005efbcd2023-11-18T00:38:59ZengMDPI AGBiomolecules2218-273X2023-04-0113577310.3390/biom13050773Cardiac Imaging Biomarkers in Chronic Kidney DiseaseSilvia C. Valbuena-López0Giovanni Camastra1Luca Cacciotti2Eike Nagel3Valentina O. Puntmann4Luca Arcari5Department of Cardiology, University Hospital La Paz, 28046 Madrid, SpainCardiology Unit, Madre Giuseppina Vannini Hospital, 00177 Rome, ItalyCardiology Unit, Madre Giuseppina Vannini Hospital, 00177 Rome, ItalyInstitute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, GermanyInstitute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, GermanyCardiology Unit, Madre Giuseppina Vannini Hospital, 00177 Rome, ItalyUremic cardiomyopathy (UC), the peculiar cardiac remodeling secondary to the systemic effects of renal dysfunction, is characterized by left ventricular (LV) diffuse fibrosis with hypertrophy (LVH) and stiffness and the development of heart failure and increased rates of cardiovascular mortality. Several imaging modalities can be used to obtain a non-invasive assessment of UC by different imaging biomarkers, which is the focus of the present review. Echocardiography has been largely employed in recent decades, especially for the determination of LVH by 2-dimensional imaging and diastolic dysfunction by pulsed-wave and tissue Doppler, where it retains a robust prognostic value; more recent techniques include parametric assessment of cardiac deformation by speckle tracking echocardiography and the use of 3D-imaging. Cardiac magnetic resonance (CMR) imaging allows a more accurate assessment of cardiac dimensions, including the right heart, and deformation by feature-tracking imaging; however, the most evident added value of CMR remains tissue characterization. T1 mapping demonstrated diffuse fibrosis in CKD patients, increasing with the worsening of renal disease and evident even in early stages of the disease, with few, but emerging, prognostic data. Some studies using T2 mapping highlighted the presence of subtle, diffuse myocardial edema. Finally, computed tomography, though rarely used to specifically assess UC, might provide incidental findings carrying prognostic relevance, including information on cardiac and vascular calcification. In summary, non-invasive cardiovascular imaging provides a wealth of imaging biomarkers for the characterization and risk-stratification of UC; integrating results from different imaging techniques can aid a better understanding of the physiopathology of UC and improve the clinical management of patients with CKD.https://www.mdpi.com/2218-273X/13/5/773Chronic kidney diseaseuremic cardiomyopathyT1 mappingT2 mappingcardiac magnetic resonancemyocardial fibrosis |
| spellingShingle | Silvia C. Valbuena-López Giovanni Camastra Luca Cacciotti Eike Nagel Valentina O. Puntmann Luca Arcari Cardiac Imaging Biomarkers in Chronic Kidney Disease Biomolecules Chronic kidney disease uremic cardiomyopathy T1 mapping T2 mapping cardiac magnetic resonance myocardial fibrosis |
| title | Cardiac Imaging Biomarkers in Chronic Kidney Disease |
| title_full | Cardiac Imaging Biomarkers in Chronic Kidney Disease |
| title_fullStr | Cardiac Imaging Biomarkers in Chronic Kidney Disease |
| title_full_unstemmed | Cardiac Imaging Biomarkers in Chronic Kidney Disease |
| title_short | Cardiac Imaging Biomarkers in Chronic Kidney Disease |
| title_sort | cardiac imaging biomarkers in chronic kidney disease |
| topic | Chronic kidney disease uremic cardiomyopathy T1 mapping T2 mapping cardiac magnetic resonance myocardial fibrosis |
| url | https://www.mdpi.com/2218-273X/13/5/773 |
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