Cardiac magnetic resonance in survivors of critical illness: myocardial fibrosis and dysfunction are associated with acute kidney injury

In this prospective study, cardiac magnetic resonance (CMR) was performed in 48 intensive care unit (ICU) survivors of acute critical illness without prior known cardiac disease. CMR revealed previously unrecognized functional abnormalities, including reduced left ventricular ejection fraction and impaired strain values, as well as evidence of focal and diffuse myocardial fibrosis represented by positive late gadolinium enhancement lesions and elevated myocardial T1 mapping and ECV. Findings were more pronounced in ICU survivors who had experienced acute kidney injury. Unrecognized fibrotic and functional myocardial alterations may be a correlate of physical impairment in post-intensive care syndrome.