Evaluation of Left Ventricular Flow Kinetic Energy by Four-Dimensional Blood Flow MRI in Nondialysis Chronic Kidney...

Area of Science:

• Cardiovascular Imaging
• Nephrology
• Biomedical Engineering

Background:

• Chronic kidney disease (CKD) significantly elevates cardiovascular disease risk.
• Left ventricular (LV) hemodynamics are affected by cardiac remodeling in CKD.
• LV hemodynamics in nondialysis CKD patients remain incompletely understood.

Purpose of the Study:

• To investigate LV kinetic energy (KE) changes in CKD patients using 4D flow MRI.
• To explore the relationship between LV KE and LV remodeling in CKD.

Main Methods:

• A retrospective study involving 98 predialysis CKD patients and 16 healthy controls.
• Utilized 4D flow MRI, T1 mapping, and T2 mapping on a 3.0 T scanner.
• Assessed LV flow components, KE parameters (normalized to end-diastolic volume), T1, and T2 values.

Main Results:

• CKD patients showed significantly increased LV KE parameters (peak systolic, systolic, diastolic, peak A-wave, global KEiEDV) and decreased KEiEDV E/A ratio compared to controls.
• Diastolic and peak E-wave KEiEDV increased with CKD stage progression.
• Global KEiEDV and direct flow proportion independently correlated with T1 and T2 mapping values.

Conclusions:

• Four-dimensional blood flow MRI reveals altered LV KE in CKD patients, reflecting cardiac adaptations.
• LV KE parameters correlate with T1 and T2 mapping, suggesting potential for assessing myocardial fibrosis and edema in CKD.