Right Ventricular Strain Analysis By Tissue Tracking Cardiac Magnetic Resonance Imaging In Pediatric Patients With End-Stage Renal Disease

Ahmed M Tawfik ^1,2, Donia M Sobh ¹, Basma Gadelhak ¹

⁰Department of Diagnostic and Interventional Radiology.

Journal of Thoracic Imaging +

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June 2, 2023

View abstract on PubMed

Summary

Right ventricular (RV) global strain, volume, and mass measured by cardiac magnetic resonance (CMR) indicate RV dysfunction in pediatric patients with end-stage renal disease (ESRD), even with preserved RV ejection fraction (RVEF). These CMR markers are crucial for assessing RV health in this population.

Area Of Science

Cardiovascular Imaging
Pediatric Nephrology
Cardiac Function Assessment

Background

Pediatric end-stage renal disease (ESRD) can lead to cardiovascular complications, including right ventricular (RV) dysfunction.
Assessing RV function in pediatric ESRD patients with preserved RV ejection fraction (RVEF) is challenging.
Cardiac magnetic resonance (CMR) offers advanced imaging capabilities for evaluating cardiac structure and function.

Purpose Of The Study

To investigate the utility of RV volume and mass by CMR as markers of RV dysfunction in pediatric ESRD patients.
To determine the added value of tissue tracking strain analysis in identifying RV dysfunction in this cohort.
To assess RV dysfunction in pediatric ESRD patients with preserved RVEF (>50%).

Main Methods

Tissue tracking CMR was employed to assess RV global longitudinal, circumferential, and radial strains.
Twenty-five pediatric ESRD patients with preserved RVEF and 10 healthy controls were analyzed.
Correlations between strain parameters, other CMR metrics, and clinical biomarkers were evaluated using binary logistic regression.

Main Results

Pediatric ESRD patients exhibited significantly higher RV end-diastolic volume and mass (RVMi) compared to controls.
All RV global strain parameters were significantly impaired in ESRD patients versus controls (P < 0.05).
RV mass (RVMi) emerged as an independent significant predictor of ESRD in multivariable analysis (OR: 0.395, P = 0.046).

Conclusions

CMR-derived RV global strain, volume, and mass are significant markers of RV dysfunction in pediatric ESRD patients.
These parameters are valuable even in the presence of preserved RVEF, highlighting subclinical RV impairment.
Tissue tracking strain analysis provides crucial insights into RV dysfunction in pediatric ESRD.