Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes
Abstract Background Late gadolinium enhancement (LGE) using cardiac magnetic resonance (CMR) characterizes myocardial disease and predicts an adverse cardiovascular (CV) prognosis. Myocardial abnormalities, are present in early chronic kidney disease (CKD). To date there are no data defining prevale...
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doaj-6d4fdac680fa41dfb69d2e38f02e67a92020-12-20T12:18:20ZengBMCBMC Cardiovascular Disorders1471-22612019-12-0119111010.1186/s12872-019-1256-3Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomesAnna M. Price0Manvir K. Hayer1Ravi Vijapurapu2Saad A. Fyyaz3William E. Moody4Charles J. Ferro5Jonathan N. Townend6Richard P. Steeds7Nicola C. Edwards8Birmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamDepartment of Cardiology, Queen Elizabeth HospitalDepartment of Cardiology, Queen Elizabeth HospitalBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamBirmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of BirminghamAbstract Background Late gadolinium enhancement (LGE) using cardiac magnetic resonance (CMR) characterizes myocardial disease and predicts an adverse cardiovascular (CV) prognosis. Myocardial abnormalities, are present in early chronic kidney disease (CKD). To date there are no data defining prevalence, pattern and clinical implications of LGE-CMR in CKD. Methods Patients with pre-dialysis CKD (stage 2–5) attending specialist renal clinics at University Hospital Birmingham (UK) who underwent gadolinium enhanced CMR (1.5 T) between 2005 and 2017 were included. The patterns and presence (LGEpos) / absence (LGEneg) of LGE were assessed by two blinded observers. Association between LGE and CV outcomes were assessed. Results In total, 159 patients received gadolinium (male 61%, mean age 55 years, mean left ventricular ejection fraction 69%, left ventricular hypertrophy 5%) with a median follow up period of 3.8 years [1.04–11.59]. LGEpos was present in 55 (34%) subjects; the patterns were: right ventricular insertion point n = 28 (51%), mid wall n = 18 (33%), sub-endocardial n = 5 (9%) and sub-epicardial n = 4 (7%). There were no differences in left ventricular structural or functional parameters with LGEpos. There were 12 adverse CV outcomes over follow up; 7 of 55 with LGEpos and 5 of 104 LGEneg. LGEpos was not predicted by age, gender, glomerular filtration rate or electrocardiographic abnormalities. Conclusions In a selected cohort of subjects with moderate CKD but low CV risk, LGE was present in approximately a third of patients. LGE was not associated with adverse CV outcomes. Further studies in high risk CKD cohorts are required to assess the role of LGE with multiplicative risk factors.https://doi.org/10.1186/s12872-019-1256-3Cardiac magnetic resonanceGadoliniumChronic kidney diseaseFibrosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anna M. Price Manvir K. Hayer Ravi Vijapurapu Saad A. Fyyaz William E. Moody Charles J. Ferro Jonathan N. Townend Richard P. Steeds Nicola C. Edwards |
spellingShingle |
Anna M. Price Manvir K. Hayer Ravi Vijapurapu Saad A. Fyyaz William E. Moody Charles J. Ferro Jonathan N. Townend Richard P. Steeds Nicola C. Edwards Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes BMC Cardiovascular Disorders Cardiac magnetic resonance Gadolinium Chronic kidney disease Fibrosis |
author_facet |
Anna M. Price Manvir K. Hayer Ravi Vijapurapu Saad A. Fyyaz William E. Moody Charles J. Ferro Jonathan N. Townend Richard P. Steeds Nicola C. Edwards |
author_sort |
Anna M. Price |
title |
Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
title_short |
Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
title_full |
Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
title_fullStr |
Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
title_full_unstemmed |
Myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
title_sort |
myocardial characterization in pre-dialysis chronic kidney disease: a study of prevalence, patterns and outcomes |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2019-12-01 |
description |
Abstract Background Late gadolinium enhancement (LGE) using cardiac magnetic resonance (CMR) characterizes myocardial disease and predicts an adverse cardiovascular (CV) prognosis. Myocardial abnormalities, are present in early chronic kidney disease (CKD). To date there are no data defining prevalence, pattern and clinical implications of LGE-CMR in CKD. Methods Patients with pre-dialysis CKD (stage 2–5) attending specialist renal clinics at University Hospital Birmingham (UK) who underwent gadolinium enhanced CMR (1.5 T) between 2005 and 2017 were included. The patterns and presence (LGEpos) / absence (LGEneg) of LGE were assessed by two blinded observers. Association between LGE and CV outcomes were assessed. Results In total, 159 patients received gadolinium (male 61%, mean age 55 years, mean left ventricular ejection fraction 69%, left ventricular hypertrophy 5%) with a median follow up period of 3.8 years [1.04–11.59]. LGEpos was present in 55 (34%) subjects; the patterns were: right ventricular insertion point n = 28 (51%), mid wall n = 18 (33%), sub-endocardial n = 5 (9%) and sub-epicardial n = 4 (7%). There were no differences in left ventricular structural or functional parameters with LGEpos. There were 12 adverse CV outcomes over follow up; 7 of 55 with LGEpos and 5 of 104 LGEneg. LGEpos was not predicted by age, gender, glomerular filtration rate or electrocardiographic abnormalities. Conclusions In a selected cohort of subjects with moderate CKD but low CV risk, LGE was present in approximately a third of patients. LGE was not associated with adverse CV outcomes. Further studies in high risk CKD cohorts are required to assess the role of LGE with multiplicative risk factors. |
topic |
Cardiac magnetic resonance Gadolinium Chronic kidney disease Fibrosis |
url |
https://doi.org/10.1186/s12872-019-1256-3 |
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