Cardiac MRI measures of LV mass index and LVEF were associated with 5-year mortality in haemodialysis patients, with each 1% LVEF increase reducing mortality risk by 3%.
Cohort
Yes
Do cardiac MRI measures (native T1, LV mass index, LVEF) associate with mortality in patients requiring maintenance haemodialysis?
In patients on maintenance hemodialysis, LV mass index and LVEF measured by cardiac MRI are associated with 5-year mortality, with LV mass index being an independent determinant.
BACKGROUND: In people with kidney failure requiring haemodialysis, sudden cardiac death and arrhythmia are prevalent causes of mortality, driven by left ventricular (LV) hypertrophy and myocardial fibrosis. Native T1, a non-contrast magnetic resonance imaging (MRI) technique, is thought to represent myocardial fibrosis in this population. We hypothesised that MRI measures of cardiac structure and function would associate with mortality. METHODS: A post-hoc, longitudinal analysis of data from the CYCLE-HD (ISRCTN11299707) and TICKER (NCT03704701) studies examined associations between native T1, LV mass index, LV ejection fraction (LVEF), and mortality over five years in people requiring haemodialysis. Cox proportional hazard models were adjusted for age, sex, diabetes, time on dialysis, and subsequent transplant. RESULTS: increase in LV mass index increased mortality risk by 2%. Each 1% increase in LVEF reduced mortality risk by 3%. In an exploratoryadjusted model that included native T1, LVMi and LVEF, only LVMi remained an independent determinant of mortality. CONCLUSION: Native T1, LV mass index, and LVEF were significant determinants of mortality in people requiring haemodialysis. T1 shows promise as a novel biomarker of myocardial fibrosis in this population. Associations between changes in T1 and mortality, and consideration of implementing findings into clinical practice needs research.
Adenwalla et al. (Wed,) conducted a cohort in Kidney failure requiring maintenance haemodialysis. Cardiac magnetic resonance imaging (native T1, LV mass index, LVEF) was evaluated on Mortality. Cardiac MRI measures of LV mass index and LVEF were associated with 5-year mortality in haemodialysis patients, with each 1% LVEF increase reducing mortality risk by 3%.