Elevated Septal Native T1 Time in CMR Imaging Suggesting Myocardial Fibrosis in Young Kidney Transplant Recipients.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2025-01-13 DOI:10.1016/j.jocmr.2025.101839

Tim Alexander Ubenauf, Jeannine von der Born, Rizky I Sugianto, Carl Grabitz, Elena Lehmann, Nima Memaran, Nele Kanzelmeyer, Jan Falk, Nigar Babazade, Samir Sarikouch, Diane Miriam Renz, Bernhard Magnus Wilhelm Schmidt, Anette Melk

{"title":"Elevated Septal Native T1 Time in CMR Imaging Suggesting Myocardial Fibrosis in Young Kidney Transplant Recipients.","authors":"Tim Alexander Ubenauf, Jeannine von der Born, Rizky I Sugianto, Carl Grabitz, Elena Lehmann, Nima Memaran, Nele Kanzelmeyer, Jan Falk, Nigar Babazade, Samir Sarikouch, Diane Miriam Renz, Bernhard Magnus Wilhelm Schmidt, Anette Melk","doi":"10.1016/j.jocmr.2025.101839","DOIUrl":null,"url":null,"abstract":"Background: Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiac magnetic resonance (CMR) imaging is already an established risk factor. Data for children after KTx are not available. This study aimed to explore cardiac function and structure with focus on myocardial fibrosis and associated risk factors in KTx recipients.Methods: 46 KTx recipients (mean age 16.0 ± 3.5 years) and 46 age- and sex-matched healthy controls were examined with non-contrast CMR imaging. Native T1 time (nT1), a marker for myocardial fibrosis, was measured at the interventricular septum. Other parameters comprised left ventricular mass index (LVMI), ejection fraction (LVEF), and global longitudinal strain (GLS). Multivariable linear regression analyses were used to explore associations with nT1.Results: Mean nT1 was significantly higher in KTx recipients than in controls (1198.1±48.8ms vs. 1154.4±23.4ms, p<0.0001). Twenty-one (46%) had a nT1 above above the upper limit of the normal range (mean + 2SD of controls). KTx recipients showed higher LVMI z-scores (0.1±1.1 vs. -0.3±0.7, p=0.026), higher LVEF (67.3±3.8% vs. 65.3±3.6%, p=0.012), and lower GLS (-19.0±2.1% vs. -20.3±2.7%, p=0.010). Higher systolic blood pressure (SBP; ß=1.284, p=0.001), LVMI (ß=1.542, p<0.001), and LVEF (ß=3.535, p=0.026) were associated with longer nT1 only in KTx recipients, but not in controls. Only two KTx recipients exhibited left ventricular hypertrophy, however, a total of 18 displayed elevated nT1 with LVMI z-score within the normal range.Conclusion: Our data suggest the presence of cardiac remodeling with myocardial fibrosis in a significant proportion of young KTx recipients. Non-contrast CMR imaging has the potential to visualize early structural cardiac changes and could become an important diagnostic adjunct in the follow-up of KTx recipients. Longitudinal studies are needed to further evaluate the importance of nT1 in early identification of those at high risk for sudden cardiac death allowing to integrate preventive strategies.","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101839"},"PeriodicalIF":4.2000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Magnetic Resonance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jocmr.2025.101839","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiac magnetic resonance (CMR) imaging is already an established risk factor. Data for children after KTx are not available. This study aimed to explore cardiac function and structure with focus on myocardial fibrosis and associated risk factors in KTx recipients.

Methods: 46 KTx recipients (mean age 16.0 ± 3.5 years) and 46 age- and sex-matched healthy controls were examined with non-contrast CMR imaging. Native T1 time (nT1), a marker for myocardial fibrosis, was measured at the interventricular septum. Other parameters comprised left ventricular mass index (LVMI), ejection fraction (LVEF), and global longitudinal strain (GLS). Multivariable linear regression analyses were used to explore associations with nT1.

Results: Mean nT1 was significantly higher in KTx recipients than in controls (1198.1±48.8ms vs. 1154.4±23.4ms, p<0.0001). Twenty-one (46%) had a nT1 above above the upper limit of the normal range (mean + 2SD of controls). KTx recipients showed higher LVMI z-scores (0.1±1.1 vs. -0.3±0.7, p=0.026), higher LVEF (67.3±3.8% vs. 65.3±3.6%, p=0.012), and lower GLS (-19.0±2.1% vs. -20.3±2.7%, p=0.010). Higher systolic blood pressure (SBP; ß=1.284, p=0.001), LVMI (ß=1.542, p<0.001), and LVEF (ß=3.535, p=0.026) were associated with longer nT1 only in KTx recipients, but not in controls. Only two KTx recipients exhibited left ventricular hypertrophy, however, a total of 18 displayed elevated nT1 with LVMI z-score within the normal range.

Conclusion: Our data suggest the presence of cardiac remodeling with myocardial fibrosis in a significant proportion of young KTx recipients. Non-contrast CMR imaging has the potential to visualize early structural cardiac changes and could become an important diagnostic adjunct in the follow-up of KTx recipients. Longitudinal studies are needed to further evaluate the importance of nT1 in early identification of those at high risk for sudden cardiac death allowing to integrate preventive strategies.

查看原文本刊更多论文

CMR成像中隔原生T1时间升高提示年轻肾移植受者心肌纤维化。

背景：儿童肾移植术后患者心脏并发症发生率高，但其潜在机制尚不清楚。在成人中，心脏磁共振（CMR）成像检测到的心肌纤维化已经是一个确定的危险因素。KTx之后的儿童数据不可用。本研究旨在探讨KTx受者的心脏功能和结构，重点关注心肌纤维化和相关危险因素。方法：对46例KTx受者（平均年龄16.0±3.5岁）和46例年龄和性别匹配的健康对照者进行非对比CMR成像检查。在室间隔处测量天然T1时间（nT1），这是心肌纤维化的标志。其他参数包括左室质量指数（LVMI）、射血分数（LVEF）和整体纵向应变（GLS）。多变量线性回归分析用于探讨与nT1的关系。结果：KTx受者的平均nT1明显高于对照组（1198.1±48.8ms vs 1154.4±23.4ms）。结论：我们的数据表明，在年轻KTx受者中，存在心肌纤维化的心脏重构。非对比CMR成像有可能显示早期心脏结构性变化，并可能成为KTx受者随访的重要诊断辅助手段。需要进行纵向研究，以进一步评估nT1在早期识别心源性猝死高危人群中的重要性，从而整合预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.