Evolving Myocardial Injury in Chronic Kidney Disease Assessed by Multiparameter Magnetic Resonance in a Rabbit Model

IF 3.5 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2025-03-20 DOI:10.1002/jmri.29768

Shiqi Jin, Fan Wang, Huaibi Huo, Zhaoxin Tian, Shutong Liu, Ting Liu

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Abstract

Background

Early diagnosis and monitoring of chronic kidney disease (CKD)-related myocardial injury are crucial for improving outcomes.

Purpose

To evaluate myocardial tissue characteristics and deformation during the occurrence and evolution of CKD in a rabbit model using multiparametric cardiac MRI.

Study Type

Longitudinal animal study.

Population

A total of 26 rabbits (14 undergoing cationic bovine serum albumin (C-BSA) injection to induce CKD, 12 undergoing sham saline injection to serve as controls).

Field Strength/Sequence

3, cine, T1 mapping, and T2 mapping sequences.

Assessment

Cardiac MRI was performed at baseline, 4, 6, and 8 weeks in both groups. Global radial, circumferential, and longitudinal strain (GRS, GCS and GLS, respectively), native T1, T2, and extracellular volume (ECV) were assessed at each time point. Collagen volume fraction (CVF) was assessed, and immunohistochemical staining was performed using the IL-6 antibody. Pathology was used as a reference standard for comparison with MRI findings. The diagnostic accuracy of individual and combined MR parameters for detecting early CKD-related myocardial injury was determined.

Statistical Tests

Descriptive statistics, Spearman correlation (r), area under the receiver operating characteristic curve (AUC). A p-value < 0.05 was considered statistically significant.

Results

Compared to controls, GLS was significantly lower, and ECV was significantly higher in the CKD group at 4 weeks post-injection. At 6 and 8 weeks, GLS was further reduced, and native T1, T2, and ECV values were significantly increased in the CKD group compared to controls. Myocardial native T1 and ECV were significantly positively correlated with CVF (r = 0.584 and 0.754, respectively), and T2 was significantly positively correlated with IL-6 (r = 0.661). The combination of native T1 and GLS showed superior diagnostic accuracy for detecting early CKD-related subclinical myocardial injury compared to single indicators (AUC = 0.846, 95% CI: 0.731–0.962).

Conclusions

The appropriate combination of cardiac MRI-based features of strain, fibrosis, and inflammation may serve as an early marker of CKD-related myocardial injury.

Evidence Level

N/A.

Technical Efficacy

Stage 2.

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用多参数磁共振评价兔模型慢性肾脏疾病心肌损伤演变。

背景：早期诊断和监测慢性肾脏疾病（CKD）相关心肌损伤对改善预后至关重要。目的：利用多参数心脏MRI评价兔CKD发生发展过程中心肌组织特征和变形。研究类型：纵向动物研究。种群：共26只兔（14只注射阳离子牛血清白蛋白（C-BSA）诱导CKD， 12只注射假生理盐水作为对照）。场强/序列：3、cine、T1映射、T2映射序列。评估：两组患者分别在基线、4周、6周和8周进行心脏MRI检查。在每个时间点评估整体径向、周向和纵向应变（分别为GRS、GCS和GLS）、原生T1、T2和细胞外体积（ECV）。评估胶原体积分数（CVF），使用IL-6抗体进行免疫组化染色。病理作为参考标准与MRI结果进行比较。确定单个和联合MR参数检测早期ckd相关心肌损伤的诊断准确性。统计检验：描述性统计、Spearman相关(r)、受试者工作特征曲线下面积（AUC）。A p值结果：与对照组相比，注射后4周，CKD组GLS显著降低，ECV显著升高。在第6周和第8周，与对照组相比，CKD组GLS进一步降低，原生T1、T2和ECV值显著升高。心肌原生T1、ECV与CVF显著正相关（r分别为0.584、0.754），T2与IL-6显著正相关（r = 0.661）。与单一指标相比，天然T1和GLS联合检测早期ckd相关亚临床心肌损伤的诊断准确性更高（AUC = 0.846, 95% CI: 0.731-0.962）。结论：心脏mri特征的适当组合，如应变、纤维化和炎症，可能是ckd相关心肌损伤的早期标志。证据级别：无。技术功效：第二阶段。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.