title: Magnetic resonance tissue phase mapping demonstrates altered left ventricular diastolic function in children with chronic kidney disease.
abstract: BACKGROUND
  Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease.
  
  
  OBJECTIVE
  To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease.
  
  
  METHODS
  Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle.
  
  
  RESULTS
  Patients and controls (age: 8 years-20 years) were matched for age, height, weight, gender and heart rate. Patients had higher systolic blood pressure. No patient had left ventricular hypertrophy on MRI or diastolic dysfunction on echocardiography. Fifteen patients underwent tissue Doppler echocardiography, with normal z-scores for mitral early diastolic (VE), late diastolic (VA) and peak systolic (VS) velocities. Throughout all left ventricular levels, peak diastolic Vz and Vr (cm/s) were reduced in patients: Vzbase-10.6 ± 1.9 vs. -13.4 ± 2.0 (P < 0.0003), Vzmid-7.8 ± 1.6 vs. -11 ± 1.5 (P < 0.0001), Vzapex-3.8 ± 1.6 vs. -5.3 ± 1.6 (P = 0.01), Vrbase-4.2 ± 0.8 vs. -4.9 ± 0.7 (P = 0.01), Vrmid-4.7 ± 0.7 vs. -5.4 ± 0.7 (P = 0.01), Vrapex-4.7 ± 1.4 vs. -5.6 ± 1.1 (P = 0.05).
  
  
  CONCLUSIONS
  Tissue phase mapping is feasible in children and adolescents. Children with chronic kidney disease show significantly reduced peak diastolic long- and short-axis left ventricular wall velocities, reflecting impaired early diastolic filling. Thus, tissue phase mapping detects chronic kidney disease-related functional myocardial changes before overt left ventricular hypertrophy or echocardiographic diastolic dysfunction occurs.
authors.affiliation: Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center - University of Freiburg, Mathildenstr. 1, 79106,, Freiburg, Germany. Charlotte.Gimpel@uniklinik-freiburg.de.
authors.forename: Charlotte
authors.identifier: http://orcid.org/0000-0003-1296-9081
authors.initials: C
authors.lastname: Gimpel
authors.affiliation: Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital Bern, Bern, Switzerland.
authors.forename: Bernd A
authors.initials: BA
authors.lastname: Jung
authors.affiliation: Department of Nuclear Medicine, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Jung
authors.affiliation: Department of Cardiology and Angiology I, University Heart Center Freiburg, Freiburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Brado
authors.affiliation: University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schwendinger
authors.affiliation: Pediatric Heart Center, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Burkhardt
authors.affiliation: Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center - University of Freiburg, Mathildenstr. 1, 79106,, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Pohl
authors.affiliation: Department of Cardiology and Angiology I, University Heart Center Freiburg, Freiburg, Germany.
authors.forename: Katja E
authors.initials: KE
authors.lastname: Odening
authors.affiliation: Department of Radiology, University Children's Hospital Zurich, Zurich, Switzerland.|Department of Radiology, Northwestern University, 737 N. Michigan Ave., Chicago, IL, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Geiger
authors.affiliation: Department of Pediatric and Congenital Cardiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Raoul
authors.initials: R
authors.lastname: Arnold
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*; D055815:Young Adult
keywords: Adolescents; Cardiac imaging technique; Cardio renal syndrome; Chronic renal failure; Left ventricular dysfunction; Magnetic resonance imaging; Tissue phase mapping