Lunzer Laura, Donà Carolina, Mascherbauer Katharina, Kronberger Christina, Nitsche Christian, Koschutnik Matthias, Poledniczek Michael, Harbich Paul Felix, Kaufmann Christoph, Pogran Edita, Kvakan Heda, Beitzke Dietrich, Loewe Christian, Geppert Alexander, Hengstenberg Christian, Kammerlander Andreas Anselm
Medical Department, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
Medical Department, Division of Cardiology and Intensive Care Medicine, Klinik Ottakring, 1160 Vienna, Austria.
J Clin Med. 2024 Dec 30;14(1):154. doi: 10.3390/jcm14010154.
Renal disease is common in patients with cardiovascular disease (CVD) and is associated with adverse outcomes. Cardiac magnetic resonance (CMR) with advanced mapping techniques is the gold standard for characterizing myocardial tissue, and renal tissue is often visualized on these maps. However, it remains unclear whether renal T1 times accurately reflect renal dysfunction or predict adverse outcomes. To analyze the relationship between renal T1 times, renal dysfunction, and adverse outcomes. Adverse outcomes were defined as all-cause and cardiovascular death. Renal T1 times were measured in the native short-axis view in an all-comers cohort undergoing CMR. Renal function parameters were assessed at the time of CMR. A total of 506 patients (mean age 60 ± 15 years, 53% male) were included in the analysis. A significant correlation was observed between log10 renal cortical T1 times and eGFR (r = -0.701, < 0.001) and creatinine (r = 0.615, < 0.001). Kaplan-Meier analysis showed an increased risk of all-cause ( < 0.001 by log-rank test) and cardiovascular mortality ( = 0.004 by log-rank test) in patients with renal cortical T1 times above the median. In the univariable Cox regression analysis, there was a significant association between renal cortical T1 times and increased risk of all-cause (HR = 1.73 [95% CI, 1.42-2.11] per every 100 ms increase < 0.001) and cardiovascular mortality (HR = 1.41 [95% CI, 1.05-1.90] per every 100 ms increase, = 0.021). This association remained statistically significant after adjustment for prespecified clinical factors (adjusted HR for all-cause death = 1.49 [95% CI, 1.10-2.02] per every 100 ms increase, = 0.01; adjusted HR for cardiovascular death = 1.42 [95% CI, 1.05-1.90] per every 100 ms increase, = 0.021). Our results indicate that there is a significant association between increased renal cortical T1 times and impaired renal function, as well as an increased risk of all-cause and cardiovascular mortality, although it should be noted that our results are preliminary and need to be validated in external cohorts performing renal biopsies.
肾脏疾病在心血管疾病（CVD）患者中很常见，且与不良结局相关。采用先进成像技术的心脏磁共振（CMR）是心肌组织特征分析的金标准，在这些图像上肾脏组织也常能被显示。然而，尚不清楚肾脏T1值是否能准确反映肾功能不全或预测不良结局。为分析肾脏T1值、肾功能不全与不良结局之间的关系。不良结局定义为全因死亡和心血管死亡。在接受CMR检查的所有患者队列中，于自然短轴视图下测量肾脏T1值。在CMR检查时评估肾功能参数。共有506例患者（平均年龄60±15岁，53%为男性）纳入分析。观察到log10肾脏皮质T1值与估算肾小球滤过率（eGFR）（r = -0.701，P<0.001）及肌酐（r = 0.615，P<0.001）之间存在显著相关性。Kaplan-Meier分析显示，肾脏皮质T1值高于中位数的患者全因死亡风险增加（对数秩检验P<0.001）以及心血管死亡风险增加（对数秩检验P = 0.004）。在单变量Cox回归分析中，肾脏皮质T1值与全因死亡风险增加之间存在显著关联（每增加100 ms，风险比[HR]=1.73[95%置信区间，1.42 - 2.11]，P<0.001）以及心血管死亡风险增加（每增加100 ms，HR = 1.41[95%置信区间，1.05 - 1.90]，P = 0.021）。在对预先设定的临床因素进行校正后，这种关联仍具有统计学意义（全因死亡校正HR = 每增加100 ms为1.49[95%置信区间，1.10 - 2.02]，P = 0.01；心血管死亡校正HR = 每增加100 ms为1.42[95%置信区间，1.05 - 1.90]，P = 0.021）。我们的结果表明，肾脏皮质T1值升高与肾功能受损以及全因和心血管死亡风险增加之间存在显著关联，不过需要注意的是，我们的结果是初步的，需要在进行肾脏活检的外部队列中进行验证。
