Abstract 16286: Myocardial Oxygenation is Reduced in End-Stage Renal Failure: A Novel Blood Oxygen Level Dependant (BOLD)-Cardiac MRI Study
Background: Cardiovascular disease is the leading cause of mortality in end-stage renal failure (ESRF), mostly from coronary artery disease (CAD). Majority is asymptomatic and current cardiac stress imaging modalities are sub-optimal. Advances in cardiovascular magnetic resonance (CMR) with the novel blood oxygen level-dependent (BOLD) technique provides capability to assess regional myocardial deoxygenation. We hypothesized that myocardial oxygenation would be reduced in ESRF patients and may form a novel strategy to assess myocardial ischemia.
Methods: Sixteen ESRF patients (7 on dialysis, 9 pre-dialysis) with no known history of CAD underwent CMR scanning at 3.0 T. Given known reductions in BOLD signals in hypertrophied myocardium, we also assessed a control group of hypertensive (HT) patients (n= 6)
To measure oxygenation, using a T2-prepared BOLD sequence, myocardial Signal Intensity (SI) was measured at adenosine stress (140 μg/kg/min) and at rest (corrected to RR interval). Comparison of myocardial SI analyses were performed using multivariate linear regression.
Results: Baseline characteristics were similar in RF and HT groups. Left and right ventricular functions were similar. Interventricular septal thickness and LV mass were similar in RF and HT groups (LV septum: 1.2 ± 0.1 cm RF vs 1.2 ± 0.1 cm HT, p>NS; LV mass index 78 ± 6 g/m2 RF vs 63 ± 4 g/m2 HT, p>NS). Rate Pressure Product (RPP) was similar in both groups. Global myocardial BOLD SI change was significantly lower in RF case compared to HT control (-1.79 ± 9.13 vs 17.36 ± 9.19, p= 0.0004). BOLD SI Change in LAD and RCA coronary artery territory level were significantly lower in RF case (Table), (although did not reach statistical significance in LCx territory).
Conclusion: ESRF patients have global reductions in myocardial oxygenation despite the degree of LVH. BOLD CMR is a promising tool to detect myocardial ischemia in ESRF population, and may form a novel risk predictor of cardiac prognosis.
- © 2013 by American Heart Association, Inc.