Impaired myocardial oxygenation response to stress in patients with chronic kidney disease

Parnham, S.; Gleadle, Jonathan; Bangalore, Sripal; Grover, Suchi; Perry, Rebecca; Woodman, Richard; Pasquale, Carmine G. De; Selvanayagam, Joseph B.

doi:10.1016/j.hlc.2015.06.543

Cited by 5 publications

(6 citation statements)

References 36 publications

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“…Recognizing the high mortality due to coronary artery disease in patients with chronic kidney disease (CKD), Parnham and colleagues investigated the myocardial oxygenation response to stress in CKD (pre-dialysis and dialysis) patients and patients who underwent renal transplant without symptoms of cardiac disease, left ventricular dysfunction, or known epicardial coronary artery disease. 26 As shown in Figure 4A, an impaired OS-CMR signal intensity was observed in CKD patients compared to normal volunteers and patients with hypertension. The same group has also demonstrated the prognostic relevance of OS-CMR in asymptomatic CKD patients; 27 major adverse cardiac events were indeed observed in 44% of CKD patients with negative oxygenation-sensitive signal intensity change as opposed to 6% of CKD patients with positive oxygenation-sensitive signal intensity ( Figure 4B).…”

Section: Utilit Yofos-cmrin Conditionsde Terminingcoronary Microva mentioning

confidence: 80%

Section: Utility Of Os‐cmr In Conditions Determining Coronary Microvamentioning

confidence: 99%

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Novel cardiovascular magnetic resonance oxygenation approaches in understanding pathophysiology of cardiac diseases

Raman

Nucifora

Selvanayagam

2018

Clin Exp Pharma Physio

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Cardiovascular magnetic resonance imaging (CMR) permits accurate phenotyping of many cardiac diseases. CMR's inherent advantages are its non-invasive nature, lack of ionizing radiation and high accuracy and reproducibility. Furthermore, it is able to assess many aspects of cardiac anatomy, structure and function. Specifically, it can characterize myocardial tissue, myocardial function, myocardial mass, myocardial blood flow/perfusion, irreversible and reversible injury, all with a high degree of accuracy and reproducibility. Hence, CMR is a powerful tool in clinical and pre-clinical research. In recent years there have been novel advances in CMR myocardial tissue characterization. Oxygenation-sensitive CMR (OS-CMR) is a novel non-invasive, contrast independent technique that permits direct quantification of myocardial tissue oxygenation, both at rest and during stress. In this review, we will address the principles of the OS-CMR technique, its recent advances and summarize the studies in the effects of oxygenation on cardiac diseases.

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Section: Utilit Yofos-cmrin Conditionsde Terminingcoronary Microva mentioning

confidence: 80%

Section: Utility Of Os‐cmr In Conditions Determining Coronary Microvamentioning

confidence: 99%

Novel cardiovascular magnetic resonance oxygenation approaches in understanding pathophysiology of cardiac diseases

Raman

Nucifora

Selvanayagam

2018

Clin Exp Pharma Physio

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“…Valvular disease might also be a marker of more vascular calcification from CKD which can in turn be related to CAD pathophysiology 39 . Myocardial oxygenation response to stress is also likely impaired in the milieu of CKD and KT(without known CAD) independent of diabetes, myocardial scarring or LVH when quantified by BOLD MRI with a significant association between the blood oxygen level‐dependent (BOLD) MRI mean signal intensity change and eGFR 40 …”

Section: Discussionmentioning

confidence: 99%

Acute coronary syndromes in the peri‐operative period after kidney transplantation in United States

Goyal

Chatterjee

et al. 2020

Clinical Transplantation

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It is well known that chronic kidney disease (CKD) is an independent risk factor for the development of cardiovascular disease (CVD). 1 The risk of cardiovascular mortality goes up with progressive decline in estimated glomerular filtration rate (eGFR). 2,3 In fact, among patients with end-stage kidney disease (ESKD), there is up to a 30-fold increase in cardiovascular and all-cause mortality. 2,4 While kidney transplantation (KT) decreases the burden of cardiovascular disease (CVD) when compared to patients who remain on dialysis, the rates of major adverse cardiovascular events (MACE) are still higher compared to the general population. 5-7 In various prospective studies, the incidence of MACE after KT range from 5% to 20% and cardiovascular events can account for over 50% of all-cause mortality in KT recipients. 7-11 These adverse cardiovascular events may occur

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“…Amongst the PAH patients, 11 (55%) had idiopathic pulmonary hypertension (iPAH), 6 (30%) patients had systemic sclerosis (SSc)-associated PAH and 3 (15%) patients had chronic thromboembolic PAH (CTEPH). All patients had right heart catheter proven diagnosis of PAH with a mean pulmonary artery pressure of 35 [30-41] mmHg and mean pulmonary capillary wedge pressure of 12 [10][11][12][13][14]…”

Section: Participants Characteristicsmentioning

confidence: 99%

“…Hence with the relative increase of deoxygenated haemoglobin there will be a decrease in OS-CMR SI. Although OS-CMR has been used to advance the understanding of myocardial ischemia and a number of LV myocardial (8)(9)(10)(11) and coronary artery disease states (6,12,13), the utility in the RV has not yet been determined. Additionally, the need for other markers of early recognition and diagnosis of PAH is paramount, particularly for individuals at higher risk for development of RV failure.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of oxygen sensitive cardiac magnetic resonance of the right ventricle in pulmonary artery hypertension

Raman

Stokes

Walls

et al. 2019

Cardiovasc. Diagn. Ther.

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Background: Progressive right ventricular (RV) dysfunction in pulmonary arterial hypertension (PAH) which is contributed by RV ischemia leads to adverse clinical outcomes. Oxygen-sensitive (OS) cardiovascular magnetic resonance (CMR) has been used to determine the in vivo myocardial oxygenation of the left ventricle (LV). The aims of the present study were therefore to determine the feasibility of RV targeted rest/ stress OS-CMR imaging in PAH patients and healthy volunteers. Methods:We prospectively recruited 20 patients with right heart catheter proven PAH and 9 healthy age matched controls (NC). The CMR examination involved standard functional imaging and OS-CMR imaging. An OS-CMR signal intensity (SI) index (stress/rest SI) was acquired at RV anterior, RV free-wall and RV inferior segments. In the LV, the OS-CMR SI index was acquired globally.Results: Reliable OS SI changes were only obtained from the RV inferior segment. As RV dysfunction in PAH is a global process, hence this segment was used in both patients and NC for further comparison. RV OS-CMR SI change between rest and stress in the NC was 17%±5% (mean ± SD). Nine of 20 (45%) of the PAH patients had a mean OS SI change of less than 9% (or ≥2 SD different from the mean values in NC).Overall, RV OS SI index between the PAH patients and NC was 11%±9% vs. 17%±5% (P=0.045) in the RV inferior segment. In the LV, the global OS-CMR SI index between the PAH patients and NC was 11%±7% vs. 21%±9% (P=0.019). There was a strong correlation between RV Inf OS-CMR SI and LV OS-CMR SI (r=0.86, P<0.001). Conclusions:In this small pilot study, pharmacological induced OS-CMR is a feasible and safe technique to identify and study myocardial oxygenation in the RV of PAH patients.

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Impaired myocardial oxygenation response to stress in patients with chronic kidney disease

Cited by 5 publications

References 36 publications

Novel cardiovascular magnetic resonance oxygenation approaches in understanding pathophysiology of cardiac diseases

Novel cardiovascular magnetic resonance oxygenation approaches in understanding pathophysiology of cardiac diseases

Acute coronary syndromes in the peri‐operative period after kidney transplantation in United States

Feasibility of oxygen sensitive cardiac magnetic resonance of the right ventricle in pulmonary artery hypertension

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