Assessment of unrecognized myocardial infarction using cardiac magnetic resonance imaging in patients with endstage renal disease

TL;DR

This study shows that cardiac MRI can detect heart damage in kidney disease patients that other tests miss.

Contribution

The study demonstrates the effectiveness of CMRI in identifying unrecognized heart issues in end-stage renal disease patients.

Findings

30% of patients showed pathological results via CMRI.

CMRI detected risk factors like scar tissue and hibernation not seen in ECG or lab tests.

High-risk patients had significantly higher mortality rates than low-risk patients.

Abstract

To assess the frequency of unrecognized myocardial infarction and identify
additional ischemic conditions, as well as to evaluate the efficacy of
cardiac magnetic resonance imaging (CMRI) in risk groups, comparing the
imaging findings with electro-cardiographic (ECG) and laboratory data in
patients with stage 5 chronic kidney disease, also known as end-stage renal
disease.

This was a prospective single-center study involving 20 patients who were
referred to our radiology department to undergo CMRI between June 2010 and
December 2011. Resting left ventricular functions and (early and late)
myocardial contrast enhancement were assessed in all patients. Laboratory
tests and ECG were conducted on all individuals. The mean duration of
clinical follow-up was 18 á 4 months.

Pathological results were seen in six (30%) of the patients in our study
sample. Scar tissue was identified as a high-risk factor in three patients
(15%), and myocardial hibernation was shown to pose a moderate risk in three
patients (15%). In the remaining 14 cases, no pathology was identified, and
the risk was therefore categorized as low. A statistically significant
disparity in mortality rates was observed between the high- and low-risk
groups (p < 0.05). There were no statistically
significant differences between the two groups in terms of the ECG and
cardiac biomarkers.

Our findings indicate that CMRI is effective in accurately categorizing risk
groups and detecting ischemic conditions, even when such events are not
evident on ECG or laboratory tests.

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