RETRACTED ARTICLE: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myo
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RESEARCH ARTICLE
Open Access
Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging Hua-yan Xu1,2,3†, Zhi-gang Yang3†, Yi Zhang3, Wan-lin Peng3, Chun-chao Xia3, Zhen-lin Li3, Yong He4, Rong Xu3, Li Rao4, Ying Peng4, Yu-ming Li3, Hong-ling Gao4 and Ying-kun Guo1,2*
Abstract Background: End-stage renal disease (ESRD) patients are at high cardiovascular risk, and myocardial fibrosis (MF) accounts for most of their cardiac events. The purpose of this study is to investigate the prognostic value and risk stratification of MF as measured by extracellular volume (ECV) on cardiac magnetic resonance (CMR) for heart failure (HF) in patients with hemodialysis-dependent ESRD. Methods: Sixty-six hemodialysis ESRD patients and 25 matched healthy volunteers were prospectively enrolled and underwent CMR to quantify multiple parameters of MF by T1 mapping and late gadolinium enhancement (LGE). All ESRD patients were followed up for 11–30 months, and the end-point met the 2016 ESC guidelines for the definition of HF. Results: Over a median follow-up of 18 months (range 11–30 months), there were 26 (39.39%) guideline-diagnosed HF patients in the entire cohort of ESRD subjects. The native T1 value was elongated, and ECV was enlarged in the HF cohort relative to the non-HF cohort and normal controls (native T1, 1360.10 ± 50.14 ms, 1319.39 ± 55.44 ms and 1276.35 ± 56.56 ms; ECV, 35.42 ± 4.42%, 31.85 ± 3.01% and 26.97 ± 1.87%; all p 28.89%) than did native T1 or post T1 value (all p < 0.05) (Fig. 4).
Discussion Long-term suffering from in vitro water sodium retention, excessive uremic toxin, dysregulation of calcium and
Xu et al. BMC Cardiovascular Disorders
(2020) 20:12
Page 6 of 12
Table 2 CMR finding in ESRD patients suffered and free of HF Normal healthy (n = 25)
ESRD free of HF (n = 40)
ESRD Suffered HF (n = 26)
EF (%)
64.99 ± 4.43
58.10 ± 6.99a
45.77 ± 17.04a,b
EDV (ml)
116.45 ± 31.32
122.22 ± 32.25
155.08 ± 63.04a
ESV (ml)
42.07 ± 9.14
52.05 ± 16.86
92.58 ± 70.56a,b
SV (ml)
78.65 ± 16.60
69.84 ± 19.17
61.73 ± 19.52a,b
Mass(g)
51.79 ± 17.31
84.63 ± 31.75
95.03 ± 29.95a,b
GRS (%)
43.13 ± 10.66
43.40 ± 14.74
31.89 ± 16.20a,b
GCS (%)a
−18.61 (−20.25, −16.90)
−18.91 (− 20.92, − 16.70)
−17.10 (− 19.04, − 12.31)a,b
GLS (%)
−16.68 ± 2.90
−15.99 ± 3.36
−12.96 ± 4.98a,b
N/A
2 (5.00%)
0
LV function
Myocardial strain
Presence of LGE Non-presence (n, %) Patchy (n, %)
N/A
17 (42.50%)
7 (26.92%)
Diffused (n, %)
N/A
21 (52.50%)
19 (73.08%)
Total enhanced volume>5SD(ml)
N/A
14.62 ± 12.79
23.13 ± 13.10b
LGE Extent>5SD(%)
N/A
13.92 ± 12.18
22.04 ± 12.47b
Native T1 values (ms)
1276.35 ± 56.56
1319.39 ± 55.44a
1360.10 ± 50.14a,b
Post-contrast T1 values (ms)
502.91 ± 30.76
497..74 ± 74.24
510.24 ± 71.21
λ (%)
49.79 ± 3.79
48.80 ± 5.81a
51.06 ± 6.24a,b
ECV (%)
26.97 ± 1.87
31.85 ± 3.01a
35.42 ± 4.42a,b
T1maps
a
b
Values are mean ± SD
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