T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Arcari, Luca; Camastra, Giovanni; Ciolina, Federica; Danti, Massimiliano; Cacciotti, Luca

doi:10.15420/cfr.2021.19

Cited by 13 publications

(8 citation statements)

References 58 publications

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“…However, cardiac MRI has evolved to become a highly accurate, preferred noninvasive diagnostic test, and can be safely conducted in CKD [56][57][58][59]. Advances in the use of noncontrast cardiac MRI have allowed characterization of myocardial composition and more precise assessment of cardiac function in patients with CKD [60]. Compared to standard echocardiography, which leads to overestimation of left ventricular mass in the setting of hypervolemia [61], cardiac MRI can directly quantify left ventricular mass with outstanding reproducibility, independent of volume status.…”

Section: Cardiac Mrimentioning

confidence: 99%

Chronic kidney disease associated cardiomyopathy: recent advances and future perspectives

Dobre,

Ahlawat,

Schelling

2024

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of review Cardiomyopathy in chronic kidney disease (CKD) is a complex condition with multiple triggers and poor prognosis. This review provides an overview of recent advances in CKD-associated cardiomyopathy, with a focus on pathophysiology, newly discovered biomarkers and potential therapeutic targets. Recent findings CKD is associated with a specific pattern of myocardial hypertrophy and fibrosis, resulting in diastolic and systolic dysfunction, and often triggered by nonatherosclerotic processes. Novel biomarkers, including amino-terminal type III procollagen peptide (PIIINP), carboxy-terminal type I procollagen peptide (PICP), FGF23, marinobufagenin, and several miRNAs, show promise for early detection and risk stratification. Treatment options for CKD-associated cardiomyopathy are limited. Sodium glucose cotransporter-2 inhibitors have been shown to reduce left ventriclemdobrex1 hypertrophy and improve ejection fraction in individuals with diabetes and mild CKD, and are currently under investigation for more advanced stages of CKD. In hemodialysis patients calcimimetic etelcalcetide resulted in a significant reduction in left ventricular mass. Summary CKD-associated cardiomyopathy is a common and severe complication in CKD. The identification of novel biomarkers may lead to future therapeutic targets. Randomized clinical trials in individuals with more advanced CKD would be well posed to expand treatment options for this debilitating condition. CKD-associated cardiomyopathy.

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Section: Cardiac Mrimentioning

confidence: 99%

Chronic kidney disease associated cardiomyopathy: recent advances and future perspectives

Dobre,

Ahlawat,

Schelling

2024

Current Opinion in Nephrology &Amp; Hypertension

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“…On the contrary, T2 mapping is specifically increased in the presence of myocardial water, therefore the combination of both of these offers more valuable information. Multiple studies have reported significant differences in T1 and T2 between CKD and subjects with normal renal function [19][20][21][22][23][24][25][26][27]80] (Table 2A). These findings include a wide range of CKD patients, not only those under replacement therapy (hemodialysis or peritoneal dialysis), but also moderately diseased patients with CrCl < 60 mL/min/m 2 .…”

Section: Diffuse Fibrosis and Edemamentioning

confidence: 99%

Cardiac Imaging Biomarkers in Chronic Kidney Disease

Valbuena-López

Camastra²,

Cacciotti³

et al. 2023

Biomolecules

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Uremic cardiomyopathy (UC), the peculiar cardiac remodeling secondary to the systemic effects of renal dysfunction, is characterized by left ventricular (LV) diffuse fibrosis with hypertrophy (LVH) and stiffness and the development of heart failure and increased rates of cardiovascular mortality. Several imaging modalities can be used to obtain a non-invasive assessment of UC by different imaging biomarkers, which is the focus of the present review. Echocardiography has been largely employed in recent decades, especially for the determination of LVH by 2-dimensional imaging and diastolic dysfunction by pulsed-wave and tissue Doppler, where it retains a robust prognostic value; more recent techniques include parametric assessment of cardiac deformation by speckle tracking echocardiography and the use of 3D-imaging. Cardiac magnetic resonance (CMR) imaging allows a more accurate assessment of cardiac dimensions, including the right heart, and deformation by feature-tracking imaging; however, the most evident added value of CMR remains tissue characterization. T1 mapping demonstrated diffuse fibrosis in CKD patients, increasing with the worsening of renal disease and evident even in early stages of the disease, with few, but emerging, prognostic data. Some studies using T2 mapping highlighted the presence of subtle, diffuse myocardial edema. Finally, computed tomography, though rarely used to specifically assess UC, might provide incidental findings carrying prognostic relevance, including information on cardiac and vascular calcification. In summary, non-invasive cardiovascular imaging provides a wealth of imaging biomarkers for the characterization and risk-stratification of UC; integrating results from different imaging techniques can aid a better understanding of the physiopathology of UC and improve the clinical management of patients with CKD.

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“…As a quantitative technique, T2 mapping is objective, reproducible, stable, and suitable for patients with renal function insufficiency or gadolinium allergy due to its gadolinium-free nature [ 5 ]. It has been applied to a number of diseases, including prostate tumors [ 6 , 7 ], breast tumors [ 8 ], ovarian cancer [ 9 ], uterine endometrial carcinoma [ 10 ], osteoarthritis [ 11 , 12 ] and myocardial-related diseases [ 13 , 14 ]. However, it is well known that the T2 value of certain tissues decreases with increasing magnetic field strength.…”

Section: Introductionmentioning

confidence: 99%

Study of T2 mapping in quantifying and discriminating uterine lesions under different magnetic field strengths: 1.5 T vs. 3.0 T

Zhu

Wang

et al. 2023

BMC Med Imaging

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Background MRI is the best imaging tool for the evaluation of uterine tumors, but conventional MRI diagnosis results rely on radiologists and contrast agents (if needed). As a new objective, reproducible and contrast-agent free quantification technique, T2 mapping has been applied to a number of diseases, but studies on the evaluation of uterine lesions and the influence of magnetic field strength are few. Therefore, the aim of this study was to systematically investigate and compare the performance of T2 mapping as a nonenhanced imaging tool in discriminating common uterine lesions between 1.5 T and 3.0 T MRI systems. Methods A total of 50 healthy subjects and 126 patients with suspected uterine lesions were enrolled in our study, and routine uterine MRI sequences with additional T2 mapping sequences were performed. T2 maps were calculated by monoexponential fitting using a custom code in MATLAB. T2 values of normal uterine structures in the healthy group and lesions (benign: adenomyosis, myoma, endometrial polyps; malignant: cervical cancer, endometrial carcinoma) in the patient group were collected. The differences in T2 values between 1.5 T MRI and 3.0 T MRI in any normal structure or lesion were compared. The comparison of T2 values between benign and malignant lesions was also performed under each magnetic field strength, and the diagnostic efficacies of the T2 value obtained through receiver operating characteristic (ROC) analysis were compared between 1.5 T and 3.0 T. Results The mean T2 value of any normal uterine structure or uterine lesion under 3.0 T MRI was significantly lower than that under 1.5 T MRI (p < 0.05). There were significant differences in T2 values between each lesion subgroup under both 1.5 T and 3.0 T MRI. Moreover, the T2 values of benign lesions (71.1 ± 22.0 ms at 1.5 T and 63.4 ± 19.1 ms at 3.0 T) were also significantly lower than those of malignant lesions (101.1 ± 4.5 ms at 1.5 T and 93.5 ± 5.1 ms at 3.0 T) under both field strengths. In the aspect of differentiating benign from malignant lesions, the area under the curve of the T2 value under 3.0 T (0.94) was significantly higher than that under 1.5 T MRI (0.90) (p = 0.02). Conclusion T2 mapping can be a potential tool for quantifying common uterine lesions, and it has better performance in distinguishing benign from malignant lesions under 3.0 T MRI.

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T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Cited by 13 publications

References 58 publications

Chronic kidney disease associated cardiomyopathy: recent advances and future perspectives

Chronic kidney disease associated cardiomyopathy: recent advances and future perspectives

Cardiac Imaging Biomarkers in Chronic Kidney Disease

Study of T2 mapping in quantifying and discriminating uterine lesions under different magnetic field strengths: 1.5 T vs. 3.0 T

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