Associations of B-type natriuretic peptide (BNP) and dialysis vintage with CMRI-derived cardiac indices in stable hemodialysis patients with a preserved left ventricular ejection fraction

Int J Cardiovasc Imaging. 2020 Nov;36(11):2265-2278. doi: 10.1007/s10554-020-01942-1. Epub 2020 Jul 19.

Abstract

To assess left ventricular myocardial native T1/T2 values and systolic strain and their associations with B-type natriuretic peptide (BNP) and dialysis vintage in hemodialysis (HD) patients with a preserved left ventricular ejection fraction (LVEF). Forty-three HD patients with end-stage renal disease (ESRD) but a preserved LVEF (≥ 50%) and 28 healthy volunteers were enrolled. BNP was measured at the time of cardiac magnetic resonance (CMR) measurements. Global native T1 and T2 values were significantly higher in the HD patients (native T1: 1056 ± 32 ms vs. 1006 ± 25 ms, p < 0.001; T2: 50 ± 3 ms vs. 46 ± 2 ms, p < 0.001) than in the controls. The mean peak global circumferential strain (GCS) and global longitudinal strain (GLS) were both significantly reduced in the HD patients compared with the controls (GCS: - 13 ± 3 vs. - 16 ± 3, p < 0.001; GLS: - 12 ± 4 vs. - 15 ± 3, p = 0.001). In the HD patients, the global native T1 value showed a positive correlation with the global T2 value (r = 0.311, p = 0.042) and significant correlations with GCS (r = 0.564, p < 0.001) and GLS (r = 0.359, p = 0.018). Significant positive correlations were found between lg BNP levels and T2 values (r = 0.569, p < 0.0001) and the left atrial volume index (LAVI) (r = 0.536, p = 0.012). GLS showed significant positive correlations with the LVMI (r = 0.354, p = 0.020) and dialysis vintage (p = 0.026; r = - 0.339) in the HD patients. HD patients with a preserved LVEF have increased native T1/T2 values and decreased strain compared to controls. T2 values and the LVAI were positively associated with BNP in HD patients.

Keywords: Cardiovascular disease; Fibrosis; Hemodialysis; Magnetic resonance imaging; Strain.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnostic imaging*
  • Cardiovascular Diseases / physiopathology
  • Case-Control Studies
  • Duration of Therapy
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Observer Variation
  • Predictive Value of Tests
  • Prospective Studies
  • Renal Dialysis*
  • Reproducibility of Results
  • Stroke Volume*
  • Ventricular Function, Left*

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain