Abstract: PO2123
A Cardiac Magnetic Resonance (CMR) Study with Native T1 Mapping in Patients Listed for a Kidney Transplant
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Yahr, Jordana, Cleveland Clinic, Cleveland, Ohio, United States
- Al-Kindi, Sadeer, University Hospitals, Cleveland, Ohio, United States
- Janus, Scott E., University Hospitals, Cleveland, Ohio, United States
- Padiyar, Aparna, University Hospitals, Cleveland, Ohio, United States
- Rahman, Mahboob, University Hospitals, Cleveland, Ohio, United States
- Rajagopalan, Sanjay, University Hospitals, Cleveland, Ohio, United States
- Huml, Anne M., Cleveland Clinic, Cleveland, Ohio, United States
- Dobre, Mirela A., University Hospitals, Cleveland, Ohio, United States
Background
Uremia causes activation of cardiac fibroblasts, a decrease in capillary density and promotes fibrosis by impairing oxygen diffusion to cardiomyocytes and promoting apoptosis. Assessment of myocardial fibrosis can be done non-invasively by non-contrast CMR T1 mapping. Though reversal of myocardial fibrosis post kidney transplant has been postulated, no study has systematically assessed it in transplant recipients compared to patients who remain on the waiting list. We aimed to assess the change in T1 maps post transplant in comparison to that in waitlisted patients.
Methods
Patients from 2 clinical sites, scheduled to receive a living kidney transplant underwent a non-contrast CMR prior to and 9 months post-transplant. An age-, sex-, race- and dialysis vintage-matched control group was selected from the patients waitlisted for a deceased donor, and had non-contrast CMR performed at baseline and after 9 months. Cardiac fibrosis measured by T1 maps were compared between the 2 groups.
Results
A total of 34 participants underwent CMR at study baseline. Mean age±SD was 55±14 years, and 13(38%) were women, 7(21%) Black and 16(47%) were on dialysis. There was no difference in baseline T1 level in pre-dialysis (1063±50 ms) vs dialysis (1062±51 ms) participants, and in transplant (1063±60 ms) vs waitlisted (1063±48 ms) participants. In multivariable adjusted models, age, diabetes, and heart failure were significantly associated with T1 levels. In a subgroup of 7 participants with available follow-up CMR, compared to control group, those transplanted had a reduction in T1 levels (-64±59 ms vs 20±49 ms, p=0.09) Figure. Participants with high baseline T1 had the least decline in follow-up T1 levels.
Conclusion
Myocardial fibrosis as measured by native CMR T1 maps is reduced post kidney transplantation and continues to worsen for patients who remain actively listed for a transplant.
Funding
- Private Foundation Support