Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping

Abstract

Background The measurement of native T1 through cardiovascular magnetic resonance (CMR) is a noninvasive method of assessing myocardial fibrosis without gadolinium contrast. No studies so far have evaluated native T1 after renal transplantation. The primary aim of the current study is to assess changes in the myocardium native T1 6 months after renal transplantation. Methods We prospectively evaluated 44 renal transplant patients with 3 T CMR exams: baseline at the beginning of transplantation and at 6 months after transplantation. Results The native T1 time was measured in the midventricular septum and decreased significantly from 1331 ± 52 ms at the baseline to 1298 ± 42 ms 6 months after transplantation ( p = 0.001). The patients were split into two groups through a two-step cluster algorithm: In cluster-1 ( n = 30) the left ventricular (LV) mass index and the prevalence of diabetes were lower. In cluster-2 ( n = 14) the LV mass index and diabetes prevalence were higher. Decrease in native T1 values was significant only in the patients in cluster-1 ( p = 0.001). Conclusions The native myocardial T1 time decreased significantly 6 months after renal transplant, which may be associated with the regression of the reactive fibrosis. The patients with greater baseline LV mass index and the diabetic group did not reach a significant decrease in T1. Electronic supplementary material The online version of this article (10.1186/s12968-019-0531-x) contains supplementary material, which is available to authorized users.

Feature-tracking cardiac magnetic resonance left ventricular global longitudinal strain improves 6 months after kidney transplantation associated with reverse remodeling, not myocardial tissue characteristics

“…The use of newer T1 mapping techniques without gadolinium (native T1) has demonstrated increased myocardial T1 relaxation times indicative of diffuse interstitial fibrosis in ESRD [13,14] and early-stage CKD [12]. Although KT was associated with reduced septal native T1 [15], probably related to reduction in diffuse interstitial fibrosis, in this study we failed to prove associations between improvements in LV GLS with reductions in native T1. It has been suggested that changes in myocardial systolic and diastolic deformation are functional markers of diffuse interstitial fibrosis.…”

“…Previous CMR studies have shown subclinical features of myocardial disease characterized by reduced left ventricular (LV) GLS and increased myocardial fibrosis, as assessed by T1 mapping, in CKD [ 12 ] and ESRD [ 13 , 14 ]. Although KT was associated with reduced myocardial fibrosis [ 15 ], previous FT-CMR [ 16 ] and speckle-tracking echocardiography (STE) [ 17 , 18 ] studies found different results about the effects of KT in LV GLS, which is the most reliable and studied strain parameter. Nevertheless, the relationships between LV GLS, cardiac structure and myocardial tissue characteristics in this setting are unknown.…”

Uraemic Cardiomyopathy: A Review of Current Literature

“… 106 Native T1 measurements, a method of assessment of myocardial fibrosis in CMRI without gadolinium contrast, was explored by Contti et al where it was found that 6 months following renal transplantation, the native myocardial T1 time decreased, suggestive of regression of reactive fibrosis. 107 These findings demonstrate significant reverse cardiac remodelling as a result of renal transplantation in this high-risk population group.…”

Feature-Tracking Left Ventricular Global Longitudinal Strain Improves 6 Months After Kidney Transplantation Associated With Reverse Remodeling, Not Myocardial Tissue Characteristics

“…The use of newer T1 mapping techniques without gadolinium (native T1) has demonstrated increased myocardial T1 relaxation times indicative of diffuse interstitial brosis in ESRD [13,14] and early-stage CKD [12]. Although KT was associated with reduced septal native T1 [15], probably related to reduction in diffuse interstitial brosis, in this study we failed to prove associations between improvements in LV GLS with reductions in native T1. It has been suggested that changes in myocardial systolic and diastolic deformation are functional markers of diffuse interstitial brosis.…”

“…Previous CMR studies have shown subclinical features of myocardial disease characterized by reduced left ventricular (LV) GLS and increased myocardial brosis, as assessed by T1 mapping, in CKD [12] and ESRD [13,14]. Although KT was associated with reduced myocardial brosis [15], previous FT-CMR [16] and speckle-tracking echocardiography (STE) [17,18] studies found different results about the effects of KT in LV GLS, which is the most reliable and studied strain parameter. Nevertheless, the relationships between LV GLS, cardiac structure and myocardial tissue characteristics in this setting are unknown.…”