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Aortic stiffness is independently associated with interstitial myocardial fibrosis by native T1 and accelerated in the presence of chronic kidney disease

  • Background: Patients with chronic kidney disease (CKD) have considerable cardiovascular morbidity and mortality. Aortic stiffness is an independent predictor of cardiovascular risk and related to left ventricular remodeling and heart failure. Myocardial fibrosis is the pathophysiological hallmark of the failing heart. Methods and results: An observational study of consecutive CKD patients (n = 276) undergoing comprehensive clinical cardiovascular magnetic resonance imaging. The relationship between aortic stiffness, myocardial fibrosis, left ventricular remodeling and the severity of chronic kidney disease was examined. Compared to age-gender matched controls with no known kidney disease (n = 242), CKD patients had considerably higher myocardial native T1 and central aortic PWV (p ≪ 0.001), as well as abnormal diastolic relaxation by E/e′ (mean) by echocardiography (p ≪ 0.01). A third of all patients had LGE, with similar proportions for the presence and the (ischaemic and non-ischaemic) pattern between the groups. PWV was strongly associated with and age, NT-proBNP and native T1 in both groups, but not with LGE presence or type; the associations were amplified in severe CKD stages. In multivariate analyses, PWV was independently associated with native T1 in both groups (p ≪ 0.01) with near two-fold increase in adjusted R2 in the presence of CKD (native T1 (10 ms) R2, B(95%CI) CKD vs. non-CKD 0.28, 0.2(0.15–0.25) vs. 0.18, 0.1(0.06–0.15), p ≪ 0.01). Conclusions: Aortic stiffness and interstitial myocardial fibrosis are interrelated; this association is accelerated in the presence of CKD, but independent of LGE. Our findings reiterate the significant contribution of CKD-related factors to the pathophysiology of cardiovascular remodeling.

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Verfasserangaben:Mengzhen Chen, Luca ArcariORCiD, Jürgen Engel, Tilo FreiwaldORCiD, Steffen Platschek, Hui Zhou, Hafisyatul ZainalORCiD, Stefan BüttnerORCiD, Andreas M. ZeiherORCiDGND, Helmut GeigerGND, Ingeborg A. HauserGND, Eike NagelORCiDGND, Valentina O. PuntmannORCiD
URN:urn:nbn:de:hebis:30:3-512695
DOI:https://doi.org/10.1016/j.ijcha.2019.100389
ISSN:2352-9067
Pubmed-Id:https://pubmed.ncbi.nlm.nih.gov/31304234
Titel des übergeordneten Werkes (Englisch):International journal of cardiology. Heart & vasculature
Verlag:Elsevier
Verlagsort:Amsterdam [u. a.]
Dokumentart:Wissenschaftlicher Artikel
Sprache:Englisch
Jahr der Fertigstellung:2019
Datum der Erstveröffentlichung:26.06.2019
Veröffentlichende Institution:Universitätsbibliothek Johann Christian Senckenberg
Datum der Freischaltung:07.10.2019
Freies Schlagwort / Tag:Aortic stiffness; Chronic kidney disease; Native T1 mapping
Jahrgang:24
Ausgabe / Heft:Art. 100389
Seitenzahl:8
Erste Seite:1
Letzte Seite:8
Bemerkung:
© 2019 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
HeBIS-PPN:455692173
Institute:Medizin / Medizin
Exzellenzcluster / Exzellenzcluster Herz-Lungen-System
DDC-Klassifikation:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Lizenz (Deutsch):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0