Abstract
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.
Highlights
Cardiac magnetic resonance imaging (CMR) including T1 mapping is increasingly used to characterize myocardial disease[1,2]
The potential association of volume status and native T1 time by cardiac magnetic resonance (CMR) was investigated in consecutive HD patients and compared with results from healthy controls
The present study indicates that systemic fluid status impacts results of myocardial native T1 mapping by CMR in HD patients
Summary
Cardiac magnetic resonance imaging (CMR) including T1 mapping is increasingly used to characterize myocardial disease[1,2]. It currently remains unclear to what extent systemic fluid overload influences CMR T1 times and whether a differentiation between fibrosis and overhydration is possible in affected patients. Patients with end-stage renal disease on maintenance hemodialysis (HD), who are closely followed with regard to their fluid status, frequently develop left ventricular hypertrophy and diastolic dysfunction[7]. This has been linked to a high prevalence of risk factors such as hypertension, coronary artery disease, chronic inflammation and diabetes[8]. The potential association of volume status and native T1 time by CMR was investigated in consecutive HD patients and compared with results from healthy controls
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