Quantitative Gadolinium-Free Cardiac Fibrosis Imaging in End Stage Renal Disease Patients Reveals A Longitudinal Correlation with Structural and Functional Decline

Tori A. Stromp, Tyler J. Spear, Rebecca M. Holtkamp, Kristin N. Andres, Joshua C. Kaine, Wissam H. Alghuraibawi, Steve W. Leung, Brandon K. Fornwalt, Moriel H. Vandsburger

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Patients with end stage renal disease (ESRD) suffer high mortality from arrhythmias linked to fibrosis, but are contraindicated to late gadolinium enhancement magnetic resonance imaging (MRI). We present a quantitative method for gadolinium-free cardiac fibrosis imaging using magnetization transfer (MT) weighted MRI, and probe correlations with widely used surrogate markers including cardiac structure and contractile function in patients with ESRD. In a sub-group of patients who returned for follow-up imaging after one year, we examine the correlation between changes in fibrosis and ventricular structure/function. Quantification of changes in MT revealed significantly greater fibrotic burden in patients with ESRD compared to a healthy age matched control cohort. Ventricular mechanics, including circumferential strain and diastolic strain rate were unchanged in patients with ESRD. No correlation was observed between fibrotic burden and concomitant measures of either circumferential or longitudinal strains or strain rates. However, among patients who returned for follow up examination a strong correlation existed between initial fibrotic burden and subsequent loss of contractile function. Gadolinium-free myocardial fibrosis imaging in patients with ESRD revealed a complex and longitudinal, not contemporary, association between fibrosis and ventricular contractile function.

Original languageEnglish
Article number16972
JournalScientific Reports
Volume8
Issue number1
DOIs
StatePublished - Dec 1 2018

Bibliographical note

Funding Information:
Dr. Hartmut Malluche, Ms. Nedda Hughes, and Ms. Kimberly McLaughlin assisted with recruitment. Dr. Jennifer Moylan analyzed serum assays. Dr. Vincent Sorrell supported protocol implementation. The American Heart Association National Affiliate (14CRP20380071) and National Institutes of Health (R01HL128592) to MV, and National Center for Advancing Translational Sciences (UL1TR000117 and TL1TR000115) to University of Kentucky provided funding. Funders had no role in data analysis or manuscript preparation.

Publisher Copyright:
© 2018, The Author(s).

ASJC Scopus subject areas

  • General

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