title: Novel cardiac nuclear magnetic resonance method for noninvasive assessment of myocardial fibrosis in hemodialysis patients.
abstract: Left ventricular hypertrophy and myocardial fibrosis frequently occur in patients with end-stage renal disease receiving hemodialysis therapy and are associated with poor prognosis. Native T1 mapping is a novel cardiac magnetic resonance imaging technique that measures native myocardial T1 relaxation, a surrogate of myocardial fibrosis. Here we compared global and segmental native myocardial T1 time and global longitudinal, circumferential and segmental strain, and cardiac function of 35 hemodialysis patients and 22 control individuals. The median native global T1 time was significantly higher in the hemodialysis than the control group (1270 vs. 1085 ms), with the septal regions of hemodialysis patients having significantly higher median T1 times than nonseptal regions (1293 vs. 1252 ms). The mean peak global circumferential strain and global longitudinal strain were both significantly reduced in hemodialysis patients compared with controls (-18.3 vs. -21.7 and -16.1 vs. -20.4, respectively). Systolic strain was also significantly reduced in the septum compared with the nonseptal myocardium in hemodialysis patients (-16.2 vs. -21.9) but not in control subjects. Global circumferential strain and longitudinal strain significantly correlated with global native T1 values (r = 0.41 and 0.55, respectively), and the septal native T1 significantly correlated with the septal systolic strain (r = 0.46). Thus, myocardial fibrosis may be assessed noninvasively with native T1 mapping; the interventricular septum appears to be particularly prone to the development of fibrosis in hemodialysis patients.
authors.affiliation: John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, United Kingdom; Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, United Kingdom; National Centre for Sport and Exercise Medicine, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom. Electronic address: mpmgb1@le.ac.uk.
authors.forename: Matthew P M
authors.initials: MP
authors.lastname: Graham-Brown
authors.affiliation: John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, United Kingdom; Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: March
authors.affiliation: John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, United Kingdom; Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, United Kingdom.
authors.forename: Darren R
authors.initials: DR
authors.lastname: Churchward
authors.affiliation: National Centre for Sport and Exercise Medicine, School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom.
authors.forename: David J
authors.initials: DJ
authors.lastname: Stensel
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, United Kingdom.
authors.forename: Anvesha
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, United Kingdom.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Arnold
authors.affiliation: John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, United Kingdom; Department of Infection Immunity and Inflammation, School of Medicine and Biological Sciences, University of Leicester, Leicester, United Kingdom; Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, United Kingdom.
authors.forename: James O
authors.initials: JO
authors.lastname: Burton
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital Leicester, Leicester, United Kingdom.
authors.forename: Gerry P
authors.initials: GP
authors.lastname: McCann
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005355:Fibrosis; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D013599:Systole
keywords: MRI; cardiorenal; fibrosis; hemodialysis; native T1; strain