RETRACTED ARTICLE: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging

BMC Cardiovascular Disorders

Yong He¹  Hong-ling Gao¹  Li Rao¹  Ying Peng¹  Chun-chao Xia²  Zhen-lin Li²  Wan-lin Peng²  Zhi-gang Yang²  Rong Xu²  Yi Zhang²  Yu-ming Li²  Ying-kun Guo³  Hua-yan Xu⁴ 

[1]Department of Cardiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, China

[2]Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, Sichuan, China

[3]Department of Radiology, West China Second University Hospital, Sichuan University, 20# South Renmin Road, 610041, Chengdu, Sichuan, China

[4]Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, 20# South Renmin Road, 610041, Chengdu, Sichuan, China

[5]Department of Radiology, West China Second University Hospital, Sichuan University, 20# South Renmin Road, 610041, Chengdu, Sichuan, China

[6]Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, 20# South Renmin Road, 610041, Chengdu, Sichuan, China

[7]Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, 610041, Chengdu, Sichuan, China

关键词: End stage renal disease;    Myocardial fibrosis;    Cardiac magnetic resonance;    T1 mapping;    ECV;    Heart failure;   

DOI  :  10.1186/s12872-019-01313-2

来源: Springer

【 摘 要 】

BackgroundEnd-stage renal disease (ESRD) patients are at high cardiovascular risk, and myocardial fibrosis (MF) accounts for most of their cardiac events. The purpose of this study is to investigate the prognostic value and risk stratification of MF as measured by extracellular volume (ECV) on cardiac magnetic resonance (CMR) for heart failure (HF) in patients with hemodialysis-dependent ESRD.MethodsSixty-six hemodialysis ESRD patients and 25 matched healthy volunteers were prospectively enrolled and underwent CMR to quantify multiple parameters of MF by T1 mapping and late gadolinium enhancement (LGE). All ESRD patients were followed up for 11–30 months, and the end-point met the 2016 ESC guidelines for the definition of HF.ResultsOver a median follow-up of 18 months (range 11–30 months), there were 26 (39.39%) guideline-diagnosed HF patients in the entire cohort of ESRD subjects. The native T1 value was elongated, and ECV was enlarged in the HF cohort relative to the non-HF cohort and normal controls (native T1, 1360.10 ± 50.14 ms, 1319.39 ± 55.44 ms and 1276.35 ± 56.56 ms; ECV, 35.42 ± 4.42%, 31.85 ± 3.01% and 26.97 ± 1.87%; all p<0.05). In the cardiac strain analysis, ECV was significantly correlated with global radial strain (GRS) (r = − 0.501, p = 0.009), global circumferential strain (GCS) (r = 0.553, p = 0.005) and global longitudinal strain (GLS) (r = 0.507, p = 0.008) in ESRD patients with HF. Cox proportional hazard regression models revealed that ECV (hazard ratio [HR] = 1.160, 95% confidence interval: 1.022 to 1.318, p = 0.022) was the only independent predictor of HF in ESRD patients. It also had a higher diagnostic accuracy for detecting MF (area under the curve [AUC] = 0.936; 95% confidence interval: 0.864 to 0.976) than native T1 and post T1 (all p ≤ 0.002). Kaplan-Meier analysis revealed that the high-ECV group had a shorter median overall survival time than the low-ECV group (18 months vs. 20 months, log-rank p = 0.046) and that ESRD patients with high ECV were more likely to have HF.ConclusionsMyocardial fibrosis quantification by ECV on CMR T1 mapping was shown to be an independent risk factor of heart failure, providing incremental prognostic value and risk stratification for cardiac events in ESRD patients.Trial registrationChinese Clinical Trial Registry ChiCTR-DND-17012976, 13/12/2017, Retrospectively registered.

【 授权许可】

CC BY