Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients
ABSTRACT: Background: Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiovascular magnetic resonance (CMR) imaging is already an establish...
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000018 |
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| author | Tim Alexander Ubenauf Jeannine von der Born Rizky I. Sugianto Carl Grabitz Elena Lehmann Nima Memaran Nele Kanzelmeyer Jan Falk Nigar Babazade Samir Sarikouch Diane Miriam Renz Bernhard Magnus Wilhelm Schmidt Anette Melk |
| author_facet | Tim Alexander Ubenauf Jeannine von der Born Rizky I. Sugianto Carl Grabitz Elena Lehmann Nima Memaran Nele Kanzelmeyer Jan Falk Nigar Babazade Samir Sarikouch Diane Miriam Renz Bernhard Magnus Wilhelm Schmidt Anette Melk |
| author_sort | Tim Alexander Ubenauf |
| collection | DOAJ |
| description | ABSTRACT: Background: Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiovascular magnetic resonance (CMR) imaging is already an established risk factor. Data for children after KTx are not available. This study aimed to explore cardiac function and structure with focus on myocardial fibrosis and associated risk factors in KTx recipients. Methods: Forty-six KTx recipients (mean age 16.0 ± 3.5 years) and 46 age- and sex-matched healthy controls were examined with non-contrast CMR imaging. Native T1 time (nT1), a marker for myocardial fibrosis, was measured at the interventricular septum. Other parameters comprised left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and global longitudinal strain (GLS). Multivariable linear regression analyses were used to explore associations with nT1. Results: Mean nT1 was significantly higher in KTx recipients compared to controls (1198.1 ± 48.8 vs 1154.4 ± 23.4 ms, p < 0.0001). 46% (21/46) had a nT1 above the upper limit of the normal range (mean + 2 standard deviations of controls). KTx recipients showed higher LVMI z-scores (0.1 ± 1.1 vs −0.3 ± 0.7, p = 0.026), higher LVEF (67.3 ± 3.8% vs 65.3 ± 3.6%, p = 0.012), and lower GLS (−19.0 ± 2.1% vs −20.3 ± 2.7%, p = 0.010). Higher systolic blood pressure (ß = 1.284, p = 0.001), LVMI (ß = 1.542, p < 0.001), and LVEF (ß = 3.535, p = 0.026) were associated with longer nT1 only in KTx recipients, but not in controls. Only 2 KTx recipients exhibited left ventricular hypertrophy; however, a total of 18 displayed elevated nT1 with LVMI z-score within the normal range. Conclusion: Our data suggest the presence of cardiac remodeling with myocardial fibrosis in a significant proportion of young KTx recipients. Non-contrast CMR imaging has the potential to visualize early structural cardiac changes and could become an important diagnostic adjunct in the follow-up of KTx recipients. Longitudinal studies are needed to further evaluate the importance of nT1 in early identification of those at high risk for sudden cardiac death allowing to integrate preventive strategies. |
| format | Article |
| id | doaj-art-33236bb8dae141cc9c9ca14e2659bc8e |
| institution | OA Journals |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-33236bb8dae141cc9c9ca14e2659bc8e2025-08-20T02:08:46ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110183910.1016/j.jocmr.2025.101839Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipientsTim Alexander Ubenauf0Jeannine von der Born1Rizky I. Sugianto2Carl Grabitz3Elena Lehmann4Nima Memaran5Nele Kanzelmeyer6Jan Falk7Nigar Babazade8Samir Sarikouch9Diane Miriam Renz10Bernhard Magnus Wilhelm Schmidt11Anette Melk12Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyInstitute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyInstitute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Cardiothoracic, Transplantation and Vascular Surgery, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyInstitute of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Corresponding author.ABSTRACT: Background: Patients after kidney transplantation (KTx) in childhood show a high prevalence of cardiac complications, but the underlying mechanism is still poorly understood. In adults, myocardial fibrosis detected in cardiovascular magnetic resonance (CMR) imaging is already an established risk factor. Data for children after KTx are not available. This study aimed to explore cardiac function and structure with focus on myocardial fibrosis and associated risk factors in KTx recipients. Methods: Forty-six KTx recipients (mean age 16.0 ± 3.5 years) and 46 age- and sex-matched healthy controls were examined with non-contrast CMR imaging. Native T1 time (nT1), a marker for myocardial fibrosis, was measured at the interventricular septum. Other parameters comprised left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and global longitudinal strain (GLS). Multivariable linear regression analyses were used to explore associations with nT1. Results: Mean nT1 was significantly higher in KTx recipients compared to controls (1198.1 ± 48.8 vs 1154.4 ± 23.4 ms, p < 0.0001). 46% (21/46) had a nT1 above the upper limit of the normal range (mean + 2 standard deviations of controls). KTx recipients showed higher LVMI z-scores (0.1 ± 1.1 vs −0.3 ± 0.7, p = 0.026), higher LVEF (67.3 ± 3.8% vs 65.3 ± 3.6%, p = 0.012), and lower GLS (−19.0 ± 2.1% vs −20.3 ± 2.7%, p = 0.010). Higher systolic blood pressure (ß = 1.284, p = 0.001), LVMI (ß = 1.542, p < 0.001), and LVEF (ß = 3.535, p = 0.026) were associated with longer nT1 only in KTx recipients, but not in controls. Only 2 KTx recipients exhibited left ventricular hypertrophy; however, a total of 18 displayed elevated nT1 with LVMI z-score within the normal range. Conclusion: Our data suggest the presence of cardiac remodeling with myocardial fibrosis in a significant proportion of young KTx recipients. Non-contrast CMR imaging has the potential to visualize early structural cardiac changes and could become an important diagnostic adjunct in the follow-up of KTx recipients. Longitudinal studies are needed to further evaluate the importance of nT1 in early identification of those at high risk for sudden cardiac death allowing to integrate preventive strategies.http://www.sciencedirect.com/science/article/pii/S1097664725000018ChildrenKidney transplantationBlood pressureMyocardial fibrosisCardiac MRISeptal native T1 time |
| spellingShingle | Tim Alexander Ubenauf Jeannine von der Born Rizky I. Sugianto Carl Grabitz Elena Lehmann Nima Memaran Nele Kanzelmeyer Jan Falk Nigar Babazade Samir Sarikouch Diane Miriam Renz Bernhard Magnus Wilhelm Schmidt Anette Melk Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients Journal of Cardiovascular Magnetic Resonance Children Kidney transplantation Blood pressure Myocardial fibrosis Cardiac MRI Septal native T1 time |
| title | Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| title_full | Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| title_fullStr | Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| title_full_unstemmed | Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| title_short | Elevated septal native T1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| title_sort | elevated septal native t1 time in cardiac magnetic resonance imaging suggesting myocardial fibrosis in young kidney transplant recipients |
| topic | Children Kidney transplantation Blood pressure Myocardial fibrosis Cardiac MRI Septal native T1 time |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000018 |
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