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Sci Rep. 2018 Nov 19;8(1):16972. doi: 10.1038/s41598-018-35394-4.

Quantitative Gadolinium-Free Cardiac Fibrosis Imaging in End Stage Renal Disease Patients Reveals A Longitudinal Correlation with Structural and Functional Decline.

Author information

1
Department of Physiology, University of Kentucky, Lexington, KY, USA.
2
Glaxo Smith Kline Research and Development, Philadelphia, PA, USA.
3
Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY, USA.
4
College of Medicine, University of Kentucky, Lexington, KY, USA.
5
Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, USA.
6
Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA.
7
Department of Imaging Science and Innovation, Geisinger, Danville, PA, USA.
8
Department of Bioengineering, University of California Berkeley, Berkeley, CA, USA. moriel@berkeley.edu.

Abstract

Patients with end stage renal disease (ESRD) suffer high mortality from arrhythmias linked to fibrosis, but are contraindicated to late gadolinium enhancement magnetic resonance imaging (MRI). We present a quantitative method for gadolinium-free cardiac fibrosis imaging using magnetization transfer (MT) weighted MRI, and probe correlations with widely used surrogate markers including cardiac structure and contractile function in patients with ESRD. In a sub-group of patients who returned for follow-up imaging after one year, we examine the correlation between changes in fibrosis and ventricular structure/function. Quantification of changes in MT revealed significantly greater fibrotic burden in patients with ESRD compared to a healthy age matched control cohort. Ventricular mechanics, including circumferential strain and diastolic strain rate were unchanged in patients with ESRD. No correlation was observed between fibrotic burden and concomitant measures of either circumferential or longitudinal strains or strain rates. However, among patients who returned for follow up examination a strong correlation existed between initial fibrotic burden and subsequent loss of contractile function. Gadolinium-free myocardial fibrosis imaging in patients with ESRD revealed a complex and longitudinal, not contemporary, association between fibrosis and ventricular contractile function.

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