IMR Press / RCM / Volume 25 / Issue 4 / DOI: 10.31083/j.rcm2504148
Open Access Original Research
Inflammation Links Cardiac Injury and Renal Dysfunction: A Cardiovascular Magnetic Resonance Study
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1 Department of Nephrology, Zhejiang Hospital, 310009 Hangzhou, Zhejiang, China
2 Department of Nephrology, Xiamen Hongai Hospital, 361000 Xiamen, Fujian, China
3 Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China
4 Department of Cardiovascular disease, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China
*Correspondence: zhaocc465@zju.edu.cn (Chengchen Zhao); duanqingqing2011@163.com (Qingqing Duan)
These authors contributed equally.
Rev. Cardiovasc. Med. 2024, 25(4), 148; https://doi.org/10.31083/j.rcm2504148
Submitted: 23 July 2023 | Revised: 7 October 2023 | Accepted: 27 October 2023 | Published: 22 April 2024
(This article belongs to the Section Cardiovascular Imaging)
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Inflammation is essential in cardiorenal syndrome, however there is still a lack of evidence proving the interaction between cardiac injury, renal dysfunction and the inflammatory response. This study aimed to illustrate the association between renal dysfunction and cardiac injury with a specific focus on the role of inflammation. Methods: A single-center, retrospective study included patients with heart failure admitted to the cardiovascular department from September 2019 to April 2022. Patients received cardiovascular magnetic resonance (CMR) imaging (T1 mapping and late gadolinium enhancement (LGE)). Demographic, creatinine and native T1 were analyzed using pearson correlation, linear regression and adjusted for confounders. Interaction and subgroup analysis were performed. Results: Finally, 50 validated heart failure (HF) patients (age 58.5 ± 14.8 years; 78.0% men) were included. Cardiac global native T1 for the high estimated glomeruar filtration rate (eGFR) group was 1117.0 ± 56.6 ms, and for the low eGFR group was 1096.5 ± 61.8 ms. Univariate analysis identified global native T1 (β = 0.16, 95% confidence interval (CI): 0.04–0.28, p = 0.014) and C-reactive protein (CRP) (β = 0.30, 95% CI: 0.15–0.45, p < 0.001) as determinants of creatinine. Multivariable linear regression analysis identified global native T1 (β = 0.12, 95% CI: 0.01–0.123, p = 0.040) as a determinant of creatinine while age and diabetes were adjusted. Significant interactions between CRP and global native T1 in relation to creatinine level (p for interaction = 0.005) were identified. Conclusions: Kidney dysfunction was associated with cardiac injury and inflammation, respectively. The interaction between myocardial injury and kidney dysfunction is contingent on the severity of the inflammatory response. Further studies were needed to identify the mechanisms of the inflammatory response in cardiorenal syndrome.

Keywords
heart failure
T1 mapping
cardiorenal syndrome
inflammation
cardiovascular magnetic resonance
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