Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal
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 t...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-11-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12968-021-00822-4 |
| _version_ | 1797204006133563392 |
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| author | Alastair J. Rankin Kenneth Mangion Jennifer S. Lees Elaine Rutherford Keith A. Gillis Elbert Edy Laura Dymock Thomas A. Treibel Aleksandra Radjenovic Rajan K. Patel Colin Berry Giles Roditi Patrick B. Mark |
| author_facet | Alastair J. Rankin Kenneth Mangion Jennifer S. Lees Elaine Rutherford Keith A. Gillis Elbert Edy Laura Dymock Thomas A. Treibel Aleksandra Radjenovic Rajan K. Patel Colin Berry Giles Roditi Patrick B. Mark |
| author_sort | Alastair J. Rankin |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T08:28:21Z |
| format | Article |
| id | doaj.art-b09bc2336d394966b648a3328f235fff |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:28:21Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-b09bc2336d394966b648a3328f235fff2024-04-16T21:23:35ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2021-11-0123111310.1186/s12968-021-00822-4Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removalAlastair J. Rankin0Kenneth Mangion1Jennifer S. Lees2Elaine Rutherford3Keith A. Gillis4Elbert Edy5Laura Dymock6Thomas A. Treibel7Aleksandra Radjenovic8Rajan K. Patel9Colin Berry10Giles Roditi11Patrick B. Mark12Institute of Cardiovascular and Medical Sciences, University of GlasgowInstitute of Cardiovascular and Medical Sciences, University of GlasgowInstitute of Cardiovascular and Medical Sciences, University of GlasgowInstitute of Cardiovascular and Medical Sciences, University of GlasgowRenal and Transplant Unit, NHS Greater Glasgow and ClydeInstitute of Cardiovascular and Medical Sciences, University of GlasgowClinical Research Imaging, NHS Greater Glasgow and ClydeInstitute for Cardiovascular Sciences and Barts Heart Centre, University College LondonInstitute of Cardiovascular and Medical Sciences, University of GlasgowRenal and Transplant Unit, NHS Greater Glasgow and ClydeInstitute of Cardiovascular and Medical Sciences, University of GlasgowInstitute of Cardiovascular and Medical Sciences, University of GlasgowInstitute of Cardiovascular and Medical Sciences, University of GlasgowAbstract 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.https://doi.org/10.1186/s12968-021-00822-4End-stage kidney diseaseHaemodialysisCardiovascularMagnetic resonance imagingLeft ventricular hypertrophy |
| spellingShingle | Alastair J. Rankin Kenneth Mangion Jennifer S. Lees Elaine Rutherford Keith A. Gillis Elbert Edy Laura Dymock Thomas A. Treibel Aleksandra Radjenovic Rajan K. Patel Colin Berry Giles Roditi Patrick B. Mark Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal Journal of Cardiovascular Magnetic Resonance End-stage kidney disease Haemodialysis Cardiovascular Magnetic resonance imaging Left ventricular hypertrophy |
| title | Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| title_full | Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| title_fullStr | Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| title_full_unstemmed | Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| title_short | Myocardial changes on 3T cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| title_sort | myocardial changes on 3t cardiovascular magnetic resonance imaging in response to haemodialysis with fluid removal |
| topic | End-stage kidney disease Haemodialysis Cardiovascular Magnetic resonance imaging Left ventricular hypertrophy |
| url | https://doi.org/10.1186/s12968-021-00822-4 |
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