The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis
Abstract Background Identifying coronary artery disease (CAD) in patients with end-stage renal disease (ESRD) is challenging. Adenosine stress native T1 mapping with cardiovascular magnetic resonance (CMR) may accurately detect obstructive CAD and microvascular dysfunction in the general population....
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12968-020-00634-y |
| _version_ | 1827280655841492992 |
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| author | Federica E Poli Gaurav S Gulsin Daniel S March Ahmed MSEK Abdelaty Kelly S Parke Joanne V Wormleighton Gerry P McCann James O Burton Matthew PM Graham-Brown |
| author_facet | Federica E Poli Gaurav S Gulsin Daniel S March Ahmed MSEK Abdelaty Kelly S Parke Joanne V Wormleighton Gerry P McCann James O Burton Matthew PM Graham-Brown |
| author_sort | Federica E Poli |
| collection | DOAJ |
| description | Abstract Background Identifying coronary artery disease (CAD) in patients with end-stage renal disease (ESRD) is challenging. Adenosine stress native T1 mapping with cardiovascular magnetic resonance (CMR) may accurately detect obstructive CAD and microvascular dysfunction in the general population. This study assessed the feasibility and reliability of adenosine stress native T1 mapping in patients on haemodialysis. Methods The feasibility of undertaking rest and adenosine stress native T1 mapping using the single-shot Modified Look-Locker inversion recovery (MOLLI) sequence was assessed in 58 patients on maintenance haemodialysis using 3 T CMR. Ten patients underwent repeat stress CMR within 2 weeks for assessment of test-retest reliability of native T1, stress T1 and delta T1 (ΔT1). Interrater and intrarater agreement were assessed in 10 patients. Exploratory analyses were undertaken to assess associations between clinical variables and native T1 values in 51 patients on haemodialysis. Results Mean age of participants was 55 ± 15 years, 46 (79%) were male, and median dialysis vintage was 21 (8; 48) months. All patients completed the scan without complications. Mean native T1 rest, stress and ΔT1 were 1261 ± 57 ms, 1297 ± 50 ms and 2.9 ± 2.5%, respectively. Interrater and intrarater agreement of rest T1, stress T1 and ΔT1 were excellent, with intraclass correlation coefficients (ICC) > 0.9 for all. Test-retest reliability of rest and stress native T1 were excellent or good (CoV 1.2 and 1.5%; ICC, 0.79 and 0.69, respectively). Test-retest reliability of ΔT1 was moderate to poor (CoV 27.4%, ICC 0.55). On multivariate analysis, CAD, diabetes mellitus and resting native T1 time were independent determinants of ΔT1 (β = − 0.275, p = 0.019; β = − 0.297, p = 0.013; β = − 0.455; p < 0.001, respectively). Conclusions Rest and adenosine stress native T1 mapping is feasible and well-tolerated amongst patients with ESRD on haemodialysis. Although rater agreement of the technique is excellent, test-retest reliability of ΔT1 is moderate to poor. Prospective studies should evaluate the relationship between this technique and established methods of CAD assessment and association with outcomes. |
| first_indexed | 2024-04-24T08:44:42Z |
| format | Article |
| id | doaj.art-ca9f482c1a3f4347a5a03299f492ce2c |
| institution | Directory Open Access Journal |
| issn | 1532-429X |
| language | English |
| last_indexed | 2024-04-24T08:44:42Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj.art-ca9f482c1a3f4347a5a03299f492ce2c2024-04-16T14:32:29ZengElsevierJournal of Cardiovascular Magnetic Resonance1532-429X2020-06-0122111310.1186/s12968-020-00634-yThe reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysisFederica E Poli0Gaurav S Gulsin1Daniel S March2Ahmed MSEK Abdelaty3Kelly S Parke4Joanne V Wormleighton5Gerry P McCann6James O Burton7Matthew PM Graham-Brown8Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalNIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS TrustNIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS TrustDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalDepartment of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield HospitalAbstract Background Identifying coronary artery disease (CAD) in patients with end-stage renal disease (ESRD) is challenging. Adenosine stress native T1 mapping with cardiovascular magnetic resonance (CMR) may accurately detect obstructive CAD and microvascular dysfunction in the general population. This study assessed the feasibility and reliability of adenosine stress native T1 mapping in patients on haemodialysis. Methods The feasibility of undertaking rest and adenosine stress native T1 mapping using the single-shot Modified Look-Locker inversion recovery (MOLLI) sequence was assessed in 58 patients on maintenance haemodialysis using 3 T CMR. Ten patients underwent repeat stress CMR within 2 weeks for assessment of test-retest reliability of native T1, stress T1 and delta T1 (ΔT1). Interrater and intrarater agreement were assessed in 10 patients. Exploratory analyses were undertaken to assess associations between clinical variables and native T1 values in 51 patients on haemodialysis. Results Mean age of participants was 55 ± 15 years, 46 (79%) were male, and median dialysis vintage was 21 (8; 48) months. All patients completed the scan without complications. Mean native T1 rest, stress and ΔT1 were 1261 ± 57 ms, 1297 ± 50 ms and 2.9 ± 2.5%, respectively. Interrater and intrarater agreement of rest T1, stress T1 and ΔT1 were excellent, with intraclass correlation coefficients (ICC) > 0.9 for all. Test-retest reliability of rest and stress native T1 were excellent or good (CoV 1.2 and 1.5%; ICC, 0.79 and 0.69, respectively). Test-retest reliability of ΔT1 was moderate to poor (CoV 27.4%, ICC 0.55). On multivariate analysis, CAD, diabetes mellitus and resting native T1 time were independent determinants of ΔT1 (β = − 0.275, p = 0.019; β = − 0.297, p = 0.013; β = − 0.455; p < 0.001, respectively). Conclusions Rest and adenosine stress native T1 mapping is feasible and well-tolerated amongst patients with ESRD on haemodialysis. Although rater agreement of the technique is excellent, test-retest reliability of ΔT1 is moderate to poor. Prospective studies should evaluate the relationship between this technique and established methods of CAD assessment and association with outcomes.http://link.springer.com/article/10.1186/s12968-020-00634-yCoronary artery diseaseMyocardial ischaemiaEnd-stage renal diseaseHaemodialysisStress T1Feasibility |
| spellingShingle | Federica E Poli Gaurav S Gulsin Daniel S March Ahmed MSEK Abdelaty Kelly S Parke Joanne V Wormleighton Gerry P McCann James O Burton Matthew PM Graham-Brown The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis Journal of Cardiovascular Magnetic Resonance Coronary artery disease Myocardial ischaemia End-stage renal disease Haemodialysis Stress T1 Feasibility |
| title | The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis |
| title_full | The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis |
| title_fullStr | The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis |
| title_full_unstemmed | The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis |
| title_short | The reliability and feasibility of non-contrast adenosine stress cardiovascular magnetic resonance T1 mapping in patients on haemodialysis |
| title_sort | reliability and feasibility of non contrast adenosine stress cardiovascular magnetic resonance t1 mapping in patients on haemodialysis |
| topic | Coronary artery disease Myocardial ischaemia End-stage renal disease Haemodialysis Stress T1 Feasibility |
| url | http://link.springer.com/article/10.1186/s12968-020-00634-y |
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