TY - JOUR
T1 - Characterisation of cardiomyopathy by cardiac and aortic magnetic resonance in patients new to hemodialysis
AU - Odudu, Aghogho
AU - Eldehni, MohamedTarek
AU - McCann, Gerry P
AU - Horsfield, Mark A
AU - Breidthardt, Tobias
AU - McIntyre, Christopher W
N1 - This study was part-funded by a National Institute for Health Research Research for Patient Benefit Grant (PB-PG-0408-16195). Dr. Odudu acknowledges the support of a British Heart Foundation Clinical Research Training Fellowship Grant (FS/11/10/28564)
PY - 2015
Y1 - 2015
N2 - Objectives Cardiomyopathy is a key factor in accelerated cardiovascular mortality in haemodialysis (HD) patients. We aimed to phenotype cardiac and vascular dysfunction by tagged cardiovascular magnetic resonance (CMR) imaging in patients recently commencing HD. Methods Fifty-four HD patients and 29 age and sex-matched controls without kidney disease were studied. Left ventricular (LV) mass, volumes, ejection fraction (EF), concentric remodelling, peak-systolic circumferential strain (PSS), peak diastolic strain rate (PDSR), LV dyssynchrony, aortic distensibility and aortic pulse wave velocity were determined. Results Global systolic function was reduced (EF 51 ± 10%, HD versus 59 ± 5%, controls, p 50% (n = 35) and the subset of HD patients without diabetes (n = 40). LV dyssynchrony was inversely correlated to diastolic function, EF and aortic distensibility. Diastolic function was inversely correlated to LV dyssynchrony, concentric remodelling, age and aortic pulse wave velocity. Conclusion Patients new to HD have multiple cardiac and aortic abnormalities as characterised by tagged CMR. Cardio-protective interventions are required from initiation of therapy. Key Points • First characterisation of cardiomyopathy by tagged CMR in haemodialysis patients. • Diastolic function was correlated to LV dyssynchrony, concentric remodelling and aortic PWV. • Reductions in strain localised to the septal and anterior wall. • Bioimpedance measures were unrelated to LV strain, suggesting volume-independent pathogenetic mechanisms. • Multiple abnormalities persisted in the HD patient subset with preserved EF or without diabetes. Keywords Aortic distensibility Dyssynchrony Cardiac magnetic resonance Cardiomyopathy Hemodialysis
AB - Objectives Cardiomyopathy is a key factor in accelerated cardiovascular mortality in haemodialysis (HD) patients. We aimed to phenotype cardiac and vascular dysfunction by tagged cardiovascular magnetic resonance (CMR) imaging in patients recently commencing HD. Methods Fifty-four HD patients and 29 age and sex-matched controls without kidney disease were studied. Left ventricular (LV) mass, volumes, ejection fraction (EF), concentric remodelling, peak-systolic circumferential strain (PSS), peak diastolic strain rate (PDSR), LV dyssynchrony, aortic distensibility and aortic pulse wave velocity were determined. Results Global systolic function was reduced (EF 51 ± 10%, HD versus 59 ± 5%, controls, p 50% (n = 35) and the subset of HD patients without diabetes (n = 40). LV dyssynchrony was inversely correlated to diastolic function, EF and aortic distensibility. Diastolic function was inversely correlated to LV dyssynchrony, concentric remodelling, age and aortic pulse wave velocity. Conclusion Patients new to HD have multiple cardiac and aortic abnormalities as characterised by tagged CMR. Cardio-protective interventions are required from initiation of therapy. Key Points • First characterisation of cardiomyopathy by tagged CMR in haemodialysis patients. • Diastolic function was correlated to LV dyssynchrony, concentric remodelling and aortic PWV. • Reductions in strain localised to the septal and anterior wall. • Bioimpedance measures were unrelated to LV strain, suggesting volume-independent pathogenetic mechanisms. • Multiple abnormalities persisted in the HD patient subset with preserved EF or without diabetes. Keywords Aortic distensibility Dyssynchrony Cardiac magnetic resonance Cardiomyopathy Hemodialysis
KW - Aortic distensibility
KW - Dyssynchrony
KW - Cardiac magnetic resonance
KW - Cardiomyopathy
KW - Hemodialysis
U2 - 10.1007/s00330-015-4096-2
DO - 10.1007/s00330-015-4096-2
M3 - Article
SN - 0938-7994
SP - 1
EP - 13
JO - European Radiology
JF - European Radiology
ER -