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Updated: May 28, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Myocardial fibrosis and tissue alterations predict cardiovascular outcomes in chronic kidney disease-a prospective

Georgios Vavilis1,2, Yeshe M Kway1, Zahra Raisi-Estabragh3,4

  • 1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, United Kingdom.

Frontiers in Cardiovascular Medicine
|May 27, 2026
PubMed

Insights

Elevated native myocardial T1, a marker of fibrosis, predicts cardiovascular death, heart failure, and atrial fibrillation in chronic kidney disease (CKD) patients. This study highlights T1-mapping

Area of Science:

  • Cardiovascular Imaging
  • Nephrology
  • Biomarkers

Background:

  • Myocardial fibrosis is a significant feature of chronic kidney disease (CKD), contributing to its high cardiovascular burden.
  • Cardiovascular magnetic resonance (CMR) T1-mapping offers non-invasive quantification of diffuse myocardial fibrosis.
  • The prognostic significance of CMR T1-mapping in CKD populations requires further investigation.

Purpose of the Study:

  • To assess the association between native myocardial T1 values and mortality and incident cardiovascular outcomes in CKD patients.
  • To utilize a virtual twin-matching framework for enhanced comparability between CKD cases and controls.
  • To investigate the prognostic value of myocardial T1 in a UK Biobank imaging cohort.

Main Methods:

  • A 1:1 virtual twin-matched case-cohort study comparing CKD patients with phenotypically matched non-CKD controls.
  • Matching criteria included demographics, comorbidities, socioeconomic status, and cardiovascular risk factors.
  • Paired analyses compared myocardial T1, and Cox models evaluated the impact of a 1-SD T1 increase on outcomes over 4.9 years.

Main Results:

  • CKD participants exhibited trend-level higher myocardial T1 values compared to controls (p=0.063).
  • CKD patients had significantly higher cumulative incidences of all-cause mortality (11.3 vs. 3.8 per 1000 person-years; p=0.049) and heart failure (12.7 vs. 3.9 per 1000 person-years; p=0.021).
  • In CKD, a 1-SD increase in T1 was linked to higher risks of cardiovascular death (HR: 3.86), heart failure (HR: 2.00), and atrial fibrillation (HR: 2.04).

Conclusions:

  • Elevated native myocardial T1 is independently associated with increased risks of cardiovascular death, heart failure, and atrial fibrillation in CKD.
  • The virtual twin-matching framework enhances cohort comparability and internal validity for mechanistic inference.
  • Precision-matched cohort designs show promise for risk stratification in multimorbid populations.
Abstract

Keywords:
CKDatrial fibrilatincardiac magnet resonance imagingchronic kidney diseaseheart faiIuremyocardial architecturemyocardial fi- brosisnon-parametric mapping

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