Key result
Myocardial extracellular volume fraction assessed by cardiac CT was significantly greater in hemodialysis patients compared to propensity-matched controls (33.8% vs 26.6%, P < 0.0001).
Why the study?
Myocardial fibrosis is associated with poor prognosis in hemodialysis patients, and contrast-enhanced cardiac CT-derived ECV quantification is a novel method to evaluate this fibrosis noninvasively.
Does cardiac CT-based myocardial extracellular volume (ECV) quantification detect increased myocardial fibrosis in hemodialysis patients compared to non-hemodialysis controls?
Observational (n=40)
No
Does cardiac CT-based myocardial extracellular volume (ECV) quantification detect increased myocardial fibrosis in hemodialysis patients compared to non-hemodialysis controls?
Absolute Event Rate: 33.8% vs 26.6%
p-value: p=<0.0001
CT-ECV may detect myocardial fibrosis in hemodialysis; leaves open prognostic utility and clinical adoption.
Extent of myocardial fibrosis in hemodialysis patients has been associated with poor prognosis. Myocardial extracellular volume (ECV) quantification using contrast enhanced cardiac computed tomography (CT) is a novel method to determine extent of myocardial fibrosis. Cardiac CT-based myocardial ECV in hemodialysis patients with those of propensity-matched non-hemodialysis control subjects were compared. Twenty hemodialysis patients (mean age, 67.4 ± 9.6 years; 80% male) and 20 propensity-matched non-hemodialysis controls (mean age, 66.3 ± 9.1 years; 85% male) who underwent comprehensive cardiac CT consisted of calcium scoring, coronary CT angiography, stress perfusion CT and delayed enhancement CT were evaluated. Myocardial ECV was significantly greater in the hemodialysis group than in the control group (33.8 ± 4.7% versus 26.6 ± 2.9%; P < 0.0001). In the hemodialysis group, modest correlation was evident between myocardial ECV and left atrial volume index (r = 0.54; P = 0.01), while there was no correlation between myocardial ECV and other cardiac parameters including left ventricular mass index and severity of myocardial ischemia. Cardiac CT-based myocardial ECV may offer a potential imaging biomarker for myocardial fibrosis in HD patients.
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Yamada et al. (2020) conducted an observational in Hemodialysis (n=40). Hemodialysis vs. Non-hemodialysis control subjects was evaluated on Myocardial extracellular volume (ECV) fraction (p=<0.0001). Myocardial extracellular volume fraction assessed by cardiac CT was significantly greater in hemodialysis patients compared to propensity-matched controls (33.8% vs 26.6%, P < 0.0001).
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