Cardicac Tissue Characteristic MR Imaging By Native T1-mapping And FT-CMR In Patients With Chronic Kidney Disease At Different Stages

Objective:Although patients with chronic kidney disease(CKD)have no obvious clinical symptoms in the early stage,damage to the cardiovascular system has begun to play a role,and myocardial fibrosis is one of the main adverse consequences of CKD progression.In this paper,the native T1 values of patients with chronic kidney disease in different stages are studied to explore the feasibility of native T1-mapping to detect CKD myocardial injury,and to explore the differences in myocardial strain between patients with chronic kidney disease and healthy volunteers.The ultimate goal is to provide valuable information for early detection of myocardial damage and cardiac dysfunction in patients with CKD.Methods:CKD patients without cardiovascular disease and diabetes diagnosed in the Department of Nephrology of the Second Affiliated Hospital of Kunming Medical University from January 2018 to January 2020,according to their glomerular filtration rate(GFR),the CKD patients divided into three groups of stage 2,stage 3,and stage 4.At the same time,collect healthy volunteers of all ages and divide them into 5 groups according to age,namely 20-29 years old,30-39 years old,40-49 years old,50-59 years old,60 years old and above,10 people in each group,volunteer from health among the patients,the age and sex matching cases of CKD patients were selected as the control group,.All patients underwent 3.0T Cardiac magnetic resonance(CMR)examination,including cardiac movies and native T1-Mapping.The CVI42 software was used to measure the native T1 value of segments 1-16 according to the AHA17 segment distribution map(bull eye diagram)(the apex of segment 17 was not within the scan range,so it was not included in the study).The heart movie sequence is imported into CVI42 software for post-processing to obtain left ventricular myocardial strain parameters,including global longitudinal peak systolic strain(GLS),global circumferential peak systolic strain(GCS),and whole heart diameter.Global strain(Global Radial peak systolic strain;GRS)The study is divided into two parts:In the first part,we compared the native T1 values of CKD patients with healthy volunteers of different ages and genders.In the second part,we compare the myocardial strain parameters of the healthy volunteers of different ages and genders of CKD.Results:Fifty healthy volunteers and 34 patients with CKD were included in the study,including CKD stage 2 patients There were 8 patients,14 patients in stage 3,and 12 patients in stage 4.The first part:? There is no statistically significant difference in the native T1 value of the same segment among healthy volunteers of all ages(P>0.05),the average values of the first 1-16 segments are:1243±29ms,1250±30ms,1249±29ms,1253±29ms,1243±32ms,1245±32ms,12 51 ±36ms,1251 ±29ms,1255 ± 32ms,1254±30ms;1248±31ms,1245±30ms,1247±32ms,1244±33ms,1255±34ms,1250±32ms.?Compared with the healthy control group,the native T1 value of the 2 and 13 segments increased in stage 2 CKD patients,the difference was statistically significant(P<0.05),while the other segments had no statistically significant difference(P>0.05).?Compared with the healthy control group,the native T1 value of the 1?2?3?4?5?6?8?9?10?11?12?13?14?15 segments was significantly increased in stage 3 CKD patients,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the native T1 value in the 7?16 segments(P>0.05).?Compared with the healthy control group,the native T1 value of the 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15segments was significantly increased in stage 4 of CKD patients.The difference was statistically significant(P<0.05),and the difference in the native T1 value in the 16 segment was not statistically significant(P>0.05).?Compared with stage 2 CKD patients,the native T1 values of 1,3,6,8,9,10,12,14 segments were significantly increased in stage 3 CKD patients,the difference was statistically significant(P<0.05).There was no statistically significant difference in the native T1 values between 2,4.5,7,11,13,15,16 segments(P>0.05);patients with stage 4 CKD 1,2,3,4,5,6,8,9,1 0,12,and 14 segments,the native T1 values were increased significantly,and the difference was statistically significant.(P<0.05).The native T1 values of segments 7,11,13,15,and 16 increased,but there was not statistically significant(P>0.05).?Compared with patients with stage 3 CKD,the native T1 values of 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16 segments increased,and the difference was not statistically significant(P>0.05).the second part:The LVEF(%)of healthy volunteers,CKD stage 2,stage 3,and stage 4 patients were 58.8±8.4,56.5±4.3.55.2±5.1,and 53.7±3.5,which were in the normal range,but compared with GRS,GCS,and GLS of each group inferred:?GRS:There was no statistically significant difference between the control group,the stage 2 and 3 CKD patients(P>0.0167),and the stage 4 CKD patients were significantly lower than the other groups,the difference was statistically significant(P<0.0167).?GCS:There was no statistically significant difference between the control group,stage 2 and 3 CKD patients(P>0.0167);CKD stage 4 patients had no statistically significant difference compared with stage 2 and 3 CKD patients(P>0.0167),but Compared with the control group,the GCS of the stage 4 CKD patients were significantly lower,the difference was statistically significant(P<0.0167).?GLS:There was no statistically significant difference between the control group,the stage 2 and 3 CKD patients(P>0.0167);the GLS of the stage 4 CKD patients was significantly lower than that of the control group,and the difference was statistically significant(P<0.0167).Conclusions:?The left ventricular myocardial native T1 value of CKD patients was higher thanthat of healthy volunteers.With the progress of CKD,the increase of native T1 value and the number of involved segments increased,suggesting that native T1 can reflect myocardial damage and myocardial fibrosis in CKD patients?The myocardial damage and fibrosis degree of CKD patients in different stages arenot same.With the progress of CKD,the myocardial damage and fibrosis degree gradually increase,and the involvement of the venticular septum begins at the earliest.?Although LVEF is in the normal range,GRS,GCS,and GLS in CKD stage 4patients all have abnormalities,suggesting that chronic kidney disease can change the compliance of myocardium,and FT-CMR strain parameters can detect myocardial abnormalities earlier than LVEF.