Defining myocardial fibrosis in haemodialysis patients with non-contrast cardiac magnetic resonance.
Defining myocardial fibrosis in haemodialysis patients with non-contrast cardiac magnetic resonance.
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DOI：
10.1186/s12872-018-0885-2
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发表时间：
2018-07-13
影响因子：
2.1
通讯作者：
McCann GP
中科院分区：
文献类型：
--
作者：
Graham-Brown MP;Singh AS;Gulsin GS;Levelt E;Arnold JA;Stensel DJ;Burton JO;McCann GP
使用晚期钆增强（LGE）测定的心肌纤维化（MF）程度可预测结局，但钆禁用于晚期肾脏疾病。我们评估了自体T1标测识别和量化主动脉瓣狭窄患者（AS）MF的能力，作为血液透析患者使用的模型。我们比较了25例AS患者在3 T下使用天然T1-映射与LGE识别增强MF区域的能力。我们评估了AS患者中由LGE半高宽（FWHM）和LGE 3标准差（3SD）定义的MF程度与9种T1阈值技术之间的一致性，阈值设置为高于正常范围（1083 ± 33 ms）2至9个标准差。测试了进一步的技术，为每个患者设置单独的T1阈值（T11 SD）。与AS患者的FWHM或3SD最一致的技术用于比较AS（n = 25）和血液透析患者（n = 25）之间的MF程度。在LGE图像上确定了26个增强区域，在T1图上确定了25个相应的离散增加的原生T1信号区域。血液透析组T1较AS组高（1279 ms ± 5.8vs1143ms ± 12.49，P < 0.01）。无信号阈值技术源自与FWHM或3SD相关的高于正常范围的标准差。AS患者的T11 SD与FWHM相关（r = 0.55），具有中度一致性（ICC = 0.64）（但与3SD无关）。与AS患者相比，血液透析患者MF的T11 SD范围更大（21.92% ± 1 vs 18.24% ± 1.4，P = 0.038），而瘢痕相关区域的T1范围也更大（1390 ± 8.7 vs 1276 ms ± 20.5，P < 0.01）。两组间远端心肌和定义为瘢痕的区域之间的相对差异无差异（111.4 ms ± 7.6 vs 133.2 ms ± 17.5，P = 0.26）。MF区域在原生T1图上可识别，但无法确定定义MF范围的绝对阈值。需要组织学研究来评估原生T1信号阈值技术的能力，以确定血液透析患者MF的程度。数据来自PRIMID-AS（NCT 01658345）和CYCLE-HD研究（ISRCTN 11299707）。
Extent of myocardial fibrosis (MF) determined using late gadolinium enhanced (LGE) predicts outcomes, but gadolinium is contraindicated in advanced renal disease. We assessed the ability of native T1-mapping to identify and quantify MF in aortic stenosis patients (AS) as a model for use in haemodialysis patients. We compared the ability to identify areas of replacement-MF using native T1-mapping to LGE in 25 AS patients at 3 T. We assessed agreement between extent of MF defined by LGE full-width-half-maximum (FWHM) and the LGE 3-standard-deviations (3SD) in AS patients and nine T1 thresholding-techniques, with thresholds set 2-to-9 standard-deviations above normal-range (1083 ± 33 ms). A further technique was tested that set an individual T1-threshold for each patient (T11SD). The technique that agreed most strongly with FWHM or 3SD in AS patients was used to compare extent of MF between AS (n = 25) and haemodialysis patients (n = 25). Twenty-six areas of enhancement were identified on LGE images, with 25 corresponding areas of discretely increased native T1 signal identified on T1 maps. Global T1 was higher in haemodialysis than AS patients (1279 ms ± 5.8 vs 1143 ms ± 12.49, P < 0.01). No signal-threshold technique derived from standard-deviations above normal-range associated with FWHM or 3SD. T11SD correlated with FWHM in AS patients (r = 0.55) with moderate agreement (ICC = 0.64), (but not with 3SD). Extent of MF defined by T11SD was higher in haemodialysis vs AS patients (21.92% ± 1 vs 18.24% ± 1.4, P = 0.038), as was T1 in regions-of-interest defined as scar (1390 ± 8.7 vs 1276 ms ± 20.5, P < 0.01). There was no difference in the relative difference between remote myocardium and regions defined as scar, between groups (111.4 ms ± 7.6 vs 133.2 ms ± 17.5, P = 0.26). Areas of MF are identifiable on native T1 maps, but absolute thresholds to define extent of MF could not be determined. Histological studies are needed to assess the ability of native-T1 signal-thresholding techniques to define extent of MF in haemodialysis patients. Data is taken from the PRIMID-AS (NCT01658345) and CYCLE-HD studies (ISRCTN11299707).
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影响因子：
24
作者：
Amado, LC;Gerber, BL;Lima, JAC
通讯作者：
Lima, JAC
影响因子：
2.3
作者：
Graham-Brown, M. P. M.;March, D. S.;Burton, J. O.
通讯作者：
Burton, J. O.
影响因子：
24
作者：
Assomull, Ravi G.;Prasad, Sanjay K.;Pennell, Dudley J.
通讯作者：
Pennell, Dudley J.
影响因子：
14
作者：
Kuruvilla, Sujith;Janardhanan, Rajesh;Antkowiak, Patrick;Keeley, Ellen C.;Adenaw, Nebiyu;Brooks, Jeremy;Epstein, Frederick H.;Kramer, Christopher M.;Salerno, Michael
通讯作者：
Salerno, Michael
影响因子：
19.6
作者：
Aoki, J;Ikari, Y;Hara, K
通讯作者：
Hara, K