Acute changes in cardiac structural and tissue characterisation parameters following haemodialysis measured using...

Area of Science:

• Cardiology
• Nephrology
• Medical Imaging

Background:

• Chronic kidney disease (CKD) is associated with cardiac structural changes, including left ventricular (LV) hypertrophy.
• Long-term hemodialysis (HD) can lead to reverse LV remodeling, but the acute effects on myocardial tissue characteristics are not fully understood.
• LV mass changes may be influenced by fluid status (edema) and fibrosis, in addition to myocyte volume.

Purpose of the Study:

• To investigate acute changes in LV mass, biventricular volumes, and myocardial tissue characteristics (native T1 and T2 mapping) immediately before and after HD in CKD patients.
• To differentiate between acute fluid shifts and true regression of LV hypertrophy following HD.
• To assess the utility of cardiovascular magnetic resonance (CMR) with multiparametric mapping in evaluating cardiac changes related to HD.

Main Methods:

• Twenty-five stable HD patients underwent non-contrast CMR scans.
• Scans included volumetric assessment and native T1 and T2 mapping, performed immediately pre- and post-HD.
• Analysis focused on changes in LV mass, biventricular volumes, native T1, and T2 values.

Main Results:

• A significant reduction in LV mass was observed post-HD (p=0.003), correlating with changes in body weight (r=0.717, p<0.001).
• Both native T1 and T2 values significantly decreased post-HD (p<0.05).
• These findings suggest an acute reduction in myocardial water content rather than regression of LV hypertrophy.

Conclusions:

• Hemodialysis induces acute changes in cardiac structure and tissue characteristics in CKD patients.
• The observed reductions in LV mass and myocardial T1/T2 values likely reflect acute fluid removal.
• CMR with multiparametric mapping is a valuable tool for assessing the immediate cardiac effects of HD.