Department of Diagnostic and Interventional Radiology, Mansoura University, Faculty of Medicine, 12 El-Gomhoreya Street, Mansoura, 35516, Egypt.
Department of Radiology, Andalusia Hospital AlShalalat, Andalusia Group for Medical Services, Alexandria, Egypt.
Sci Rep. 2022 Jun 30;12(1):11079. doi: 10.1038/s41598-022-15017-9.
Renal disease is associated with increased arterial stiffness. The aim was to investigate the effect of renal disease on regional aortic strain and distensibility in children with chronic kidney disease (CKD) by cardiac magnetic resonance imaging (MRI). The study included 30 children with CKD on hemodialysis, and ten healthy control subjects. Using cardiac MRI, maximal and minimal aortic areas were measured in axial cine steady state free precision images at the ascending aorta, proximal descending, and aorta at diaphragm. Regional strain and distensibility were calculated using previously validated formulas. Second reader aortic areas measurements were used to assess inter-observer agreement. Ascending aorta strain was significantly reduced in patients (38.4 ± 17.4%) compared to the control group (56.1 ± 17%), p-value 0.011. Ascending Aorta distensibility was significantly reduced in patients (9.1 ± 4.4 [× 10 mm Hg]) compared to the control group (13.9 ± 4.9 [× 10 mm Hg]), p-value 0.006. Strain and distensibility were reduced in proximal descending aorta and aorta at diaphragm but did not reach statistical significance. Only ascending aorta strain and distensibility had significant correlations with clinical and cardiac MRI parameters. Inter-observer agreement for strain and distensibility was almost perfect or strong in the three aortic regions. Aortic strain and distensibility by cardiac MRI are important imaging biomarkers for initial clinical evaluation and follow up of children with CKD.
肾脏疾病与动脉僵硬度增加有关。本研究旨在通过心脏磁共振成像（MRI）来探讨肾脏疾病对慢性肾脏病（CKD）患儿区域性主动脉应变和顺应性的影响。该研究纳入了 30 名接受血液透析的 CKD 患儿和 10 名健康对照者。通过心脏 MRI，在升主动脉、近降主动脉和膈肌处的主动脉轴向电影稳态自由进动图像上测量最大和最小主动脉面积。使用先前验证的公式计算区域性应变和顺应性。第二读者的主动脉面积测量值用于评估观察者间的一致性。与对照组（56.1±17%）相比，患者的升主动脉应变明显降低（38.4±17.4%），p 值为 0.011。与对照组（13.9±4.9[×10mm Hg]）相比，患者的升主动脉顺应性明显降低（9.1±4.4[×10mm Hg]），p 值为 0.006。在近降主动脉和膈肌处的主动脉应变和顺应性降低，但未达到统计学意义。只有升主动脉应变和顺应性与临床和心脏 MRI 参数具有显著相关性。在三个主动脉区域，应变和顺应性的观察者间一致性几乎为极好或强。心脏 MRI 的主动脉应变和顺应性是 CKD 患儿初始临床评估和随访的重要影像学生物标志物。
