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European Radiology
Published in: European Radiology 8/2016

Open Access 01-08-2016 | Cardiac

Characterisation of cardiomyopathy by cardiac and aortic magnetic resonance in patients new to hemodialysis

Authors: Aghogho Odudu, Mohamed Tarek Eldehni, Gerry P. McCann, Mark A. Horsfield, Tobias Breidthardt, Christopher W. McIntyre

Published in: European Radiology | Issue 8/2016

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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/m2 versus 46[42,53]g/m2, 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.
Appendix
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Metadata
Title
Characterisation of cardiomyopathy by cardiac and aortic magnetic resonance in patients new to hemodialysis
Authors
Aghogho Odudu
Mohamed Tarek Eldehni
Gerry P. McCann
Mark A. Horsfield
Tobias Breidthardt
Christopher W. McIntyre
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4096-2

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