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Myocardial perfusion is impaired in asymptomatic renal and liver transplant recipients: a cardiovascular magnetic resonance study.
- Source :
-
Journal of Cardiovascular Magnetic Resonance (BioMed Central) . Jul2015, Vol. 17 Issue 1, p1-9. 9p. 1 Color Photograph, 3 Charts, 4 Graphs. - Publication Year :
- 2015
-
Abstract
- Background: Myocardial ischemia is a major cause of death in chronic kidney disease (CKD) patients, which can be caused by either epicardial or microvascular coronary artery disease (CAD). Although renal transplantation improves survival, cardiovascular disease remains a major cause of mortality in post renal transplant recipients, including those with no significant epicardial CAD pre-transplant. We aim to utilize stress cardiovascular magnetic resonance (CMR) and MR coronary angiography (MRCA) to assess silent myocardial ischemia and epicardial CAD in renal transplant recipients. Methods: Forty-five subjects: twenty renal transplant (RT) with no known CAD, fifteen liver transplant (LT) controls without prior CKD and no known CAD, and ten hypertensive (HT) controls underwent stress perfusion CMR and MRCA. Results: A total of 1308 myocardial segments (576 of RT, 468 of LT, and 264 of HT) were compared using mixed linear modeling. Left ventricular mass index, septal diameter and presence of diabetes mellitus were similar between the groups. The mean transmural MPRI was significantly lower in the RT and LT groups compared to HT controls (1.19 ± 0.50 in RT versus 1.23 ± 0.36 in LT versus 2.04 ± 0.32 in HT controls, p < 0.0001), in the subepicardium (1.33 ± 0.57 in RT versus 1.30 ± 0.33 in LT versus 2.01 ± 0.30 in HT controls, p < 0.001), and in the subendocardium (1.19 ± 0.54 in RT versus 1.11 ± 0.31 in LT versus 1.85 ± 0.34 in HT controls, p < 0.0001). Seven (35 %) RT and five (33 %) LT had significant epicardial CAD compared to none in HT controls, p = 0.12. One RT and one LT had LGE suggesting sub-endocardial infarction. Conclusions: RT recipients have impaired myocardial perfusion independent of LVH or diabetes mellitus. The impaired myocardial perfusion in RT is similar to LT without prior renal disease, thus unlikely related to previous CKD. It is not fully explained by the presence of significant epicardial CAD, and therefore most likely represents microvascular CAD. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DIAGNOSIS
*CORONARY disease
*ACADEMIC medical centers
*ANALYSIS of variance
*CARDIOVASCULAR disease diagnosis
*CONFIDENCE intervals
*FISHER exact test
*KIDNEY transplantation
*LIVER transplantation
*MAGNETIC resonance imaging
*PERFUSION
*RADIONUCLIDE imaging
*STATISTICS
*T-test (Statistics)
*TRANSPLANTATION of organs, tissues, etc.
*DATA analysis
*DATA analysis software
*DESCRIPTIVE statistics
*MAGNETIC resonance angiography
Subjects
Details
- Language :
- English
- ISSN :
- 1532429X
- Volume :
- 17
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiovascular Magnetic Resonance (BioMed Central)
- Publication Type :
- Academic Journal
- Accession number :
- 108658222
- Full Text :
- https://doi.org/10.1186/s12968-015-0166-5