Abstract: SA-PO1032
Longitudinal Changes of Myocardial Sodium Accumulation in Patients on Hemodialysis
Session Information
- Hemodialysis: Risk Factors, Epidemiology, and Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mussnig, Sebastian, Medizinische Universitat Wien, Vienna, Austria
- Tan, Josephine L., Western University, London, Ontario, Canada
- Deleaval, Patrik, London Health Sciences Center Research Institute, London, Ontario, Canada
- Hecking, Manfred, Medizinische Universitat Wien, Vienna, Austria
- Nagel, Armin M., Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, BY, Germany
- Scholl, Timothy J., Western University, London, Ontario, Canada
- McIntyre, Chris, Western University, London, Ontario, Canada
- Akbari, Alireza, Western University, London, Ontario, Canada
Background
We previously reported elevated myocardial tissue sodium concentration (TSC) in hemodialysis (HD) patients compared to healthy controls, with septal TSC associating with markers of myocardial fibrosis and injury. Whether myocardial sodium deposits evolve over time in maintenance HD is unknown.
Methods
HD patients underwent repeat cardiac proton and sodium MRI at 3.0 T on a non-dialysis day of a short interdialytic interval. Septal TSC was quantified from sensitivity-corrected sodium images and additionally rescaled by the error of right ventricular plasma sodium relative to serum sodium (corrected septal TSC). Within-subject changes were assessed by paired Wilcoxon tests. Predictors were explored by ANCOVA of follow-up corrected septal TSC on baseline and each candidate modifier.
Results
Nine HD patients (median age 40 [IQR 36-57] years; 56% women) were rescanned after 11.9 [7.6-12.0] months (Figure 1). Septal TSC remained stable (32.7 [30.0-43.2] vs. 31.7 [30.4-43.4] mM; p=0.73), as did native septal T1 (1308 [1302-1348] vs. 1318 [1310-1323] ms; p=1.0) and troponin T (80 [48-126] vs. 46 [21-105] ng/L; p=0.30). Native septal T2 increased modestly (40.1 [37.8-42.2] vs. 41.2 [40.3-42.7] ms; p=0.04) and corrected septal TSC numerically (44.6 [41.5-45.8] vs. 46.6 [43.1-53.6] mM; p=0.25). In exploratory ANCOVA, no candidate modifier (changes in fluid overload, serum sodium, septal T1, troponin T, or baseline dialysate sodium) significantly predicted follow-up corrected septal TSC, although a trend toward higher follow-up TSC was observed with decreasing fluid overload (β=−3.35 mM per +1 L, 95% CI: −7.23 to +0.53, p=0.08).
Conclusion
Myocardial sodium deposits in HD patients increased to a small, non-significant degree over approximately one year, while a small increase in native septal T2 suggests an evolving edema component. No modifier predicted within-subject change in septal TSC, warranting further analyses.
Acknowledgment
The authors wish to thank Benjamin Wilk, Jonathan D Thiessen, Justin Dorie, Tanya Tamasi and Amy Freeman for their contribution to this work.
Cardiac proton and sodium MRI in one hemodialysis patient at baseline and after 12 months. Short-axis cine, native T1, native T2, and sodium TSC. RV, right ventricle; LV, left ventricle; TSC, tissue sodium concentration.