Cardiac magnetic resonance for assessment of cardiac structure and function after renal transplantation in patients with end-stage renal disease
10.16571/j.cnki.1008-8199.2019.04.008
- VernacularTitle: 终末期肾病患者肾移植术后心脏结构和功能的心脏磁共振评价
- Author:
Wei WANG
1
;
Xue-feng NI
2
;
Li QI
1
;
Chang-sheng ZHOU
1
;
Meng-jie LU
1
;
Ke-nan XIE
2
;
Ji-qiu WEN
2
;
Long-jiang ZHANG
1
;
Guang-ming LU
1
Author Information
1. Department of Medical Imaging,ingling Hosptal,Nanjing University School of Medicine / General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu,China
2. National Clinical Research Center of Kidney Diseases,Jingling Hosptal,Nanjing University School of Medicine / General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu,China
- Publication Type:Journal Article
- Keywords:
uremic cardiomyopathy;
cardiac magnetic resonance;
end-stage renal disease;
native T1 relaxation times;
diffuse myocardial fibrosis
- From:
Journal of Medical Postgraduates
2019;32(4):374-379
- CountryChina
- Language:Chinese
-
Abstract:
Objective Few clinical studies have been reported on the reversibility of uremic cardiomyopathy (UC) after renal transplantation. This article aimed to investigate the cardiac structure and function of end-stage renal disease (ESRD) patients undergoing renal transplantation using cardiac magnetic resonance (CMR). Methods This study included 38 ESRD patients undergoing renal transplantation in the National Clinical Research Center for Kidney Diseases, General Hospital of Eastern Theater Command, from September 2015 to February 2017. All the patients received initial CMR examination at 1－2 days before renal transplantation and during the postoperative follow-up. At the median follow-up time of 3.5 (3.4-3.7), 7.0 (3.7-9.5) and 8.4 (7.1-12.7) months, we recorded the CMR parameters, including the left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), end-diastolic mass (LVEDM), end-systolic mass (LVESM), ejection fraction (LVEF), and native myocardial T1 relaxation time, and compared the parameters obtained before and after surgery. Results Twenty-five of the patients completed the postoperative follow-up, who averaged 27.5 years of age, with no history of diabetes mellitus or ischemic heart disease, and treated by dialysis for 1.7 (1.5-2.2) years. At 7.0 months after renal transplantation, as compared with the baseline, the patients showed significant decreases in the LVEDV ([96.7 ± 22.8] vs [83.4 ± 17.4] mL/m², P < 0.05), LVESV ([44.3 ± 14.8] vs [33.0 ± 10.9] mL/m², P < 0.05) and LVEDM ([67.1 ± 24.2] vs [59.0 ± 17.0] mL/m², P < 0.05), but an increase in the LVEF ([54.1 ± 10.6] % vs [60.9 ± 9.6] %, P < 0.01). The LVEDV and LVESV were also remarkably lower at 3.5 and 8.4 months than the baseline (P < 0.001), and so were the left ventricular at basal, mid, apical and global native T1 relaxation times at 3.5, 7.0 and 8.4 months (P < 0.05). Conclusion For young ESRD patients with no history of diabetes mellitus or ischemic heart disease and on short-term dialysis, left ventricular dilatation, systolic dysfunction and diffuse myocardial fibrosis are reversible after renal transplantation. Native T1 relaxation time can be used as a sensitive indicator to evaluate the degree of diffuse myocardial fibrosis in ESRD patients.
