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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2017

Open Access 01-12-2017 | Research

Native T1 mapping: inter-study, inter-observer and inter-center reproducibility in hemodialysis patients

Authors: Matthew P. M. Graham-Brown, Elaine Rutherford, E. Levelt, Daniel S. March, Darren R. Churchward, David J. Stensel, Christie McComb, Kenneth Mangion, Samantha Cockburn, Colin Berry, James C. Moon, Patrick B. Mark, James O. Burton, Gerry P. McCann

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

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Abstract

Background

Native T1 mapping is a cardiovascular magnetic resonance (CMR) technique that associates with markers of fibrosis and strain in hemodialysis patients. The reproducibility of T1 mapping in hemodialysis patients, prone to changes in fluid status, is unknown. Accurate quantification of myocardial fibrosis in this population has prognostic potential.

Methods

Using 3 Tesla CMR, we report the results of 1) the inter-study, inter-observer and intra-observer reproducibility of native T1 mapping in 10 hemodialysis patients; 2) inter-study reproducibility of left ventricular (LV) structure and function in 10 hemodialysis patients; 3) the agreement of native T1 map and native T1 phantom analyses between two centres in 20 hemodialysis patients; 4) the effect of changes in markers of fluid status on native T1 values in 10 hemodialysis patients.

Results

Inter-study, inter-observer and intra-observer variability of native T1 mapping were excellent with co-efficients of variation (CoV) of 0.7, 0.3 and 0.4% respectively. Inter-study CoV for LV structure and function were: LV mass = 1%; ejection fraction = 1.1%; LV end-diastolic volume = 5.2%; LV end-systolic volume = 5.6%. Inter-centre variability of analysis techniques were excellent with CoV for basal and mid-native T1 slices between 0.8–1.2%. Phantom analyses showed comparable native T1 times between centres, despite different scanners and acquisition sequences (centre 1: 1192.7 ± 7.5 ms, centre 2: 1205.5 ± 5 ms). For the 10 patients who underwent inter-study testing, change in body weight (Δweight) between scans correlated with change in LV end-diastolic volume (ΔLVEDV) (r = 0.682;P = 0.03) representing altered fluid status between scans. There were no correlations between change in native T1 between scans (ΔT1) and ΔLVEDV or Δweight (P > 0.6). Linear regression confirmed ΔT1 was unaffected by ΔLVEDV or Δweight (P > 0.59).

Conclusions

Myocardial native T1 is reproducible in HD patients and unaffected by changes in fluid status at the levels we observed. Native T1 mapping is a potential imaging biomarker for myocardial fibrosis in patients with end-stage renal disease.
Appendix
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Literature
1.
U.S. Renal Data System. USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. 2006.
2.
Glassock RJ, Pecoits-Filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol. 2009;4 Suppl 1:S79–91.CrossRefPubMed
3.
Pierdomenico SD, Cuccurullo F. Risk reduction after regression of echocardiographic left ventricular hypertrophy in hypertension: a meta-analysis. Am J Hypertens. 2010;23(8):876–81.CrossRefPubMed
4.
Mancini GB, Dahlof B, Diez J. Surrogate markers for cardiovascular disease: structural markers. Circulation. 2004;109(25 Suppl 1):IV22–30.PubMed
5.
Badve SV, Palmer SC, Strippoli GF, Roberts MA, Teixeira-Pinto A, Boudville N, et al. The Validity of Left Ventricular Mass as a Surrogate End Point for All-Cause and Cardiovascular Mortality Outcomes in People With CKD: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2016;68(4):554-63.
6.
Mall G, Huther W, Schneider J, Lundin P, Ritz E. Diffuse intermyocardiocytic fibrosis in uraemic patients. Nephrol Dial Transplant. 1990;5(1):39–44.CrossRefPubMed
7.
Aoki J, Ikari Y, Nakajima H, Mori M, Sugimoto T, Hatori M, et al. Clinical and pathologic characteristics of dilated cardiomyopathy in hemodialysis patients. Kidney Int. 2005;67(1):333–40.CrossRefPubMed
8.
Mark P, Johnston N, Groenning B, Foster J, Blyth K, Martin T, et al. Redefinition of uremic cardiomyopathy by contrast-enhanced cardiac magnetic resonance imaging. Kidney Int. 2006;69(10):1839–45.CrossRefPubMed
9.
Kribben A, Witzke O, Hillen U, Barkhausen J, Daul AE, Erbel R. Nephrogenic systemic fibrosis: pathogenesis, diagnosis, and therapy. J Am Coll Cardiol. 2009;53(18):1621–8.CrossRefPubMed
10.
Kehr E, Sono M, Chugh SS, Jerosch-Herold M. Gadolinium-enhanced magnetic resonance imaging for detection and quantification of fibrosis in human myocardium in vitro. Int J Cardiovasc Imaging. 2008;24(1):61–8.CrossRefPubMed
11.
Flett AS, Sado DM, Quarta G, Mirabel M, Pellerin D, Herrey AS, et al. Diffuse myocardial fibrosis in severe aortic stenosis: an equilibrium contrast cardiovascular magnetic resonance study. Eur Heart J Cardiovasc Imaging. 2012;13(10):819–26.CrossRefPubMed
12.
Bull S, White SK, Piechnik SK, Flett AS, Ferreira VM, Loudon M, et al. Human non-contrast T1 values and correlation with histology in diffuse fibrosis. Heart. 2013;99(13):932–7.CrossRefPubMedPubMedCentral
13.
Hinojar R, Varma N, Child N, Goodman B, Jabbour A, Yu CY, et al. T1 Mapping in Discrimination of Hypertrophic Phenotypes: Hypertensive Heart Disease and Hypertrophic Cardiomyopathy: Findings From the International T1 Multicenter Cardiovascular Magnetic Resonance Study. Circ Cardiovasc Imaging. 2015 8(12):10.​1161/​CIRCIMAGING.​115.​003285.
14.
Singh A, Horsfield MA, Bekele S, Khan JN, Greiser A, McCann GP. Myocardial T1 and extracellular volume fraction measurement in asymptomatic patients with aortic stenosis: reproducibility and comparison with age-matched controls. Eur Heart J Cardiovasc Imaging. 2015;16(7):763–70.CrossRefPubMed
15.
Rogers T, Dabir D, Mahmoud I, Voigt T, Schaeffter T, Nagel E, et al. Standardization of T1 measurements with MOLLI in differentiation between health and disease–the ConSept study. J Cardiovasc Magn Reson. 2013;15(1):1.CrossRef
16.
Pica S, Sado DM, Maestrini V, Fontana M, White SK, Treibel T, et al. Reproducibility of native myocardial T1 mapping in the assessment of Fabry disease and its role in early detection of cardiac involvement by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2014;16:99-014-0099-4.
17.
Rutherford E, Talle MA, Mangion K, Bell E, Rauhalammi SM, Roditi G, et al. Defining myocardial tissue abnormalities in end-stage renal failure with cardiac magnetic resonance imaging using native T1 mapping. Kidney Int. 2016;90(4):845-52.
18.
Graham-Brown MP, March DS, Churchward DR, Stensel DJ, Singh A, Arnold R, et al. Novel cardiac nuclear magnetic resonance method for noninvasive assessment of myocardial fibrosis in hemodialysis patients. Kidney Int. 2016;90(4):835–44.CrossRefPubMed
19.
Shroff GR, Raggi P. Exploring the elusive link between subclinical fibrosis and clinical events in end-stage renal disease: does cardiac magnetic resonance imaging hold the key? Kidney Int. 2016;90(4):729–32.CrossRefPubMed
20.
Captur G, Gatehouse P, Kellman P, Heslinga FG, Keenan K, Bruehl R, et al. A T1 and ECV phantom for global T1 mapping quality assurance: The T 1 mapping and ECV standardisation in CMR (T1MES) program. J Cardiovasc Magn Reson. 2016;18(1):1.CrossRef
21.
Graham-Brown M, March D, Churchward D, Young H, Dungey M, Lloyd S, et al. Design and methods of CYCLE-HD: improving cardiovascular health in patients with end stage renal disease using a structured programme of exercise: a randomised control trial. BMC Nephrol. 2016;17(1):1.CrossRef
22.
Kramer CM, Barkhausen J, Flamm SD, Kim RJ, Nagel E. Standardized cardiovascular magnetic resonance (CMR) protocols 2013 update. J Cardiovasc Magn Reson. 2013;15(1):1.CrossRef
23.
Messroghli DR, Radjenovic A, Kozerke S, Higgins DM, Sivananthan MU, Ridgway JP. Modified Look‐Locker inversion recovery (MOLLI) for high‐resolution T1 mapping of the heart. Magn Reson Med. 2004;52(1):141–6.CrossRefPubMed
24.
Dabir D, Child N, Kalra A, Rogers T, Gebker R, Jabbour A, et al. Reference values for healthy human myocardium using a T1 mapping methodology: results from the International T1 Multicenter cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2014;16(1):69.CrossRefPubMedPubMedCentral
25.
Singh A, Steadman CD, Khan JN, Horsfield MA, Bekele S, Nazir SA, et al. Intertechnique agreement and interstudy reproducibility of strain and diastolic strain rate at 1.5 and 3 tesla: A comparison of feature‐tracking and tagging in patients with aortic stenosis. J Magn Reson Imaging. 2015;41(4):1129–37.CrossRefPubMed
26.
Carrick D, Haig C, Rauhalammi S, Ahmed N, Mordi I, McEntegart M, et al. Prognostic significance of infarct core pathology revealed by quantitative non-contrast in comparison with contrast cardiac magnetic resonance imaging in reperfused ST-elevation myocardial infarction survivors. Eur Heart J. 2016;37(13):1044–59.CrossRefPubMed
27.
Rauhalammi SM, Mangion K, Barrientos PH, Carrick DJ, Clerfond G, McClure J, et al. Native myocardial longitudinal (T1) relaxation time: Regional, age, and sex associations in the healthy adult heart. J Magn Reson Imaging. 2016;44(3):541-8.
28.
Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307–10.CrossRef
29.
Liu S, Han J, Nacif MS, Jones J, Kawel N, Kellman P, et al. Diffuse myocardial fibrosis evaluation using cardiac magnetic resonance T1 mapping: sample size considerations for clinical trials. J Cardiovasc Magn Reson. 2012;14(1):1.CrossRef
30.
Piechnik SK, Ferreira VM, Dall’Armellina E, Cochlin LE, Greiser A, Neubauer S, et al. Shortened Modified Look-Locker Inversion recovery (ShMOLLI) for clinical myocardial T1-mapping at 1.5 and 3 T within a 9 heartbeat breathhold. J Cardiovasc Magn Reson. 2010;12(1):1.CrossRef
31.
Edwards NC, Moody WE, Yuan M, Hayer MK, Ferro CJ, Townend JN, et al. Diffuse Interstitial Fibrosis and Myocardial Dysfunction in Early Chronic Kidney Disease. Am J Cardiol. 2015;115(9):1311–7.CrossRefPubMed
32.
Hinojar R, Foote L, Ucar EA, Jackson T, Jabbour A, Yu C, et al. Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. J Am Coll Cardiol Img. 2015;8(1):37–46.CrossRef
33.
Caglar K, Hakim RM, Ikizler TA. Approaches to the reversal of malnutrition, inflammation, and atherosclerosis in end-stage renal disease. Nutr Rev. 2002;60(11):378–87.CrossRefPubMed
34.
Karamitsos TD, Piechnik SK, Banypersad SM, Fontana M, Ntusi NB, Ferreira VM, et al. Noncontrast T1 mapping for the diagnosis of cardiac amyloidosis. J Am Coll Cardiol Img. 2013;6(4):488–97.CrossRef
35.
Hunold P, Vogt FM, Heemann UW, Zimmermann U, Barkhausen J. Myocardial mass and volume measurement of hypertrophic left ventricles by MRI--study in dialysis patients examined before and after dialysis. J Cardiovasc Magn Reson. 2003;5(4):553–61.CrossRefPubMed
36.
McIntyre CW, Odudu A, Eldehni MT. Cardiac assessment in chronic kidney disease. Curr Opin Nephrol Hypertens. 2009;18(6):501–6.CrossRefPubMed
37.
Sado DM, Flett AS, Moon JC. Novel imaging techniques for diffuse myocardial fibrosis. Futur Cardiol. 2011;7(5):643–50.CrossRef
38.
Linz W, Wiemer G, Schaper J, Zimmermann R, Nagasawa K, Gohlke P, et al. Angiotensin converting enzyme inhibitors, left ventricular hypertrophy and fibrosis. Mol Cell Biochem. 1995;147(1-2):89–97.CrossRefPubMed
39.
Simko F, Pechanova O. Remodelling of the heart and vessels in experimental hypertension: advances in protection. J Hypertens. 2010;28 Suppl 1:S1–6.CrossRefPubMed
40.
Krayenbuehl HP, Hess OM, Monrad ES, Schneider J, Mall G, Turina M. Left ventricular myocardial structure in aortic valve disease before, intermediate, and late after aortic valve replacement. Circulation. 1989;79(4):744–55.CrossRefPubMed
41.
Chan CT, Li GH, Valaperti A, Liu P. Intensive Hemodialysis Preserved Cardiac injury. ASAIO J. 2015;61(5):613–9.CrossRefPubMed
42.
London GM, Pannier B, Guerin AP, Blacher J, Marchais SJ, Darne B, et al. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol. 2001;12(12):2759–67.PubMed
Metadata
Title
Native T1 mapping: inter-study, inter-observer and inter-center reproducibility in hemodialysis patients
Authors
Matthew P. M. Graham-Brown
Elaine Rutherford
E. Levelt
Daniel S. March
Darren R. Churchward
David J. Stensel
Christie McComb
Kenneth Mangion
Samantha Cockburn
Colin Berry
James C. Moon
Patrick B. Mark
James O. Burton
Gerry P. McCann
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI
https://doi.org/10.1186/s12968-017-0337-7

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