Key result
Systemic fluid overload in hemodialysis patients was associated with significantly longer native myocardial T1 times compared to normovolemic patients and healthy controls (1,042 vs 1,005 vs 998 ms, p=0.030).
Why the study?
Does systemic volume status impact native T1 mapping times on cardiac magnetic resonance in hemodialysis patients compared to healthy controls?
Cross-Sectional (n=72)
No
Does systemic volume status impact native T1 mapping times on cardiac magnetic resonance in hemodialysis patients compared to healthy controls?
Absolute Event Rate: 1042% vs 1005%
p-value: p=0.030
Systemic fluid overload significantly prolongs native T1 times on cardiac MRI, indicating that patient volume status must be accounted for when using T1 mapping to quantify myocardial fibrosis.
Fluid overload may prolong myocardial T1 in hemodialysis patients; hypothesis-generating for T1 mapping, requiring prospective validation.
Diffuse myocardial fibrosis is a key pathophysiologic feature in heart failure and can be quantified by cardiac magnetic resonance (CMR) T1 mapping. However, increases in myocardial free water also prolong native T1 times and may impact fibrosis quantification. Thus far, the impact of systemic patient volume status remains unclear. In this study, native T1 time by CMR was investigated in hemodialysis (HD) patients (n = 37) and compared with healthy controls (n = 35). Volume status was quantified by bioimpedance spectroscopy and correlated with CMR T1 time. While no differences between HD patients and controls were present with regard to age (p = 0.180), height (p = 0.535), weight (p = 0.559) and left ventricular (LV) ejection fraction (p = 0.273), cardiac size was significantly larger in HD patients (LV end-diastolic volume 164 ± 53 vs. 132 ± 26 ml, p = 0.002). Fluid overloaded HD patients had significantly longer native T1 times than normovolemic HD patients and healthy controls (1,042 ± 46 vs. 1,005 ± 49 vs. 998 ± 47 ms, p = 0.030). By regression analysis, T1 time was significantly associated with fluid status (r = 0.530, p = 0.009, post-HD fluid status). Our data strongly indicate that native CMR T1 time is significantly influenced by systemic volume status. As fluid overload is common in patients with cardiovascular diseases, this finding is important and requires further study.
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Antlanger et al. (2018) conducted a cross-sectional in End-stage renal disease on hemodialysis (n=72). Systemic fluid overload vs. Normovolemia was evaluated on Native myocardial T1 time (p=0.030). Systemic fluid overload in hemodialysis patients was associated with significantly longer native myocardial T1 times compared to normovolemic patients and healthy controls (1,042 vs 1,005 vs 998 ms, p=0.030).
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