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肾移植可减少心肌纤维化。一项应用原生 T1 映射的心血管磁共振研究。

Kidney transplantation is associated with reduced myocardial fibrosis. A cardiovascular magnetic resonance study with native T1 mapping.

机构信息

Department of Internal Medicine, UNESP, Univ Estadual Paulista, Rubião Jr, s/n, Botucatu/SP, 18.618-970, Brazil.

Radiology Division, UNIFESP, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

J Cardiovasc Magn Reson. 2019 Mar 27;21(1):21. doi: 10.1186/s12968-019-0531-x.

Abstract

BACKGROUND

The measurement of native T1 through cardiovascular magnetic resonance (CMR) is a noninvasive method of assessing myocardial fibrosis without gadolinium contrast. No studies so far have evaluated native T1 after renal transplantation. The primary aim of the current study is to assess changes in the myocardium native T1 6 months after renal transplantation.

METHODS

We prospectively evaluated 44 renal transplant patients with 3 T CMR exams: baseline at the beginning of transplantation and at 6 months after transplantation.

RESULTS

The native T1 time was measured in the midventricular septum and decreased significantly from 1331 ± 52 ms at the baseline to 1298 ± 42 ms 6 months after transplantation (p = 0.001). The patients were split into two groups through a two-step cluster algorithm: In cluster-1 (n = 30) the left ventricular (LV) mass index and the prevalence of diabetes were lower. In cluster-2 (n = 14) the LV mass index and diabetes prevalence were higher. Decrease in native T1 values was significant only in the patients in cluster-1 (p = 0.001).

CONCLUSIONS

The native myocardial T1 time decreased significantly 6 months after renal transplant, which may be associated with the regression of the reactive fibrosis. The patients with greater baseline LV mass index and the diabetic group did not reach a significant decrease in T1.

摘要

背景

心血管磁共振(CMR)测量心肌固有 T1 是一种评估心肌纤维化的非侵入性方法,无需钆对比剂。迄今为止,尚无研究评估肾移植后的心肌固有 T1。本研究的主要目的是评估肾移植后 6 个月心肌固有 T1 的变化。

方法

我们前瞻性评估了 44 例接受 3T CMR 检查的肾移植患者:移植开始时的基线和移植后 6 个月。

结果

在中室间隔测量了固有 T1 时间,从基线时的 1331±52ms 显著下降到 6 个月时的 1298±42ms(p=0.001)。通过两步聚类算法将患者分为两组:在聚类 1(n=30)中,左心室(LV)质量指数和糖尿病患病率较低。在聚类 2(n=14)中,LV 质量指数和糖尿病患病率较高。只有聚类 1 中的患者固有 T1 值的下降具有统计学意义(p=0.001)。

结论

肾移植后 6 个月,心肌固有 T1 时间明显下降,这可能与反应性纤维化的消退有关。基线 LV 质量指数较高和糖尿病组的患者 T1 值未显著下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9ee/6437926/b769a7981c2f/12968_2019_531_Fig1_HTML.jpg

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