Characterisation of cardiomyopathy by cardiac and aortic magnetic resonance in patients new to hemodialysis.
Eur Radiol
; 26(8): 2749-61, 2016 Aug.
Article
em En
| MEDLINE
| ID: mdl-26679178
ABSTRACT
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 < 0.001; PSS 15.9 ± 3.7% versus 19.5 ± 3.3%, p < 0.001). Diastolic function was decreased (PDSR 1.07 ± 0.33s(-1) versus 1.31 ± 0.38s(-1), p = 0.003). LV mass index was increased (63[54,79]g/m(2) versus 46[42,53]g/m(2), p < 0.001). Anteroseptal reductions in PSS were apparent. These abnormalities remained prevalent in the subset of HD patients with preserved EF >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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aorta
/
Função Ventricular Esquerda
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Diálise Renal
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Imagem Cinética por Ressonância Magnética
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Falência Renal Crônica
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Cardiomiopatias
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article