Description

Mapping of left ventricular (LV) native T1 is a promising non-invasive, non-contrast imaging biomarker. Native myocardial T1 times are prolonged in patients requiring dialysis, but there are concerns that the dialysis process and fluctuating fluid status may confound results in this population. We aimed to assess the changes in cardiac parameters on 3T cardiovascular magnetic resonance (CMR) before and after haemodialysis, with a specific focus on native T1 mapping.

Purpose/Objective

What is the current state/problem in practice?

Structural cardiac abnormalities are well described in people with advanced chronic kidney disease requiring dialysis. However, it is unclear what effect the dialysis process itself has on the reported abnormalities.  In particular, mapping of native myocardial T1 is a promising non-invasive, non-contrast imaging biomarker. Native myocardial T1 times are prolonged in people requiring dialysis compared to controls without kidney disease and this is thought to be due to interstitial myocardial fibrosis. However, there are concerns that the dialysis process and fluctuating fluid status may confound results in this population and contribute to the raised T1 times observed. 

What is the ideal state/ if the problem is gone?

The present study raises awareness that acute changes in cardiac volumes and myocardial composition are detectable on 3T cardiovascular MRI following a single session of haemodialysis in people who undergo regular haemodialysis. In particular, small but consistent reductions in myocardial native T1 times are observed after dialysis, meaning that in clinical practice care should be taken to standardise the timing of the scan in relation to a person's usual dialysis schedule, especially if serial scanning is required.

Learning Objectives

To close the gap outlined above:

1. Learners need to know about: Being aware of the ability of a single haemodialysis session to modulate cardiovascular MRI findings in relation to myocardial volumes and tissue composition.

Accreditation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Claiming CME

• Attend the sessions in full for which credit is sought
• Complete the post-activity evaluation
• A certificate of completion will be available once the evaluation is submitted

Financial Disclosures
The planners and faculty for this activity did not have any relationships to disclose.

Disclosure of Commercial Suppor

None

Bibliography
Please see the bibliography at the end of the journal article.