BACKGROUND Late gadolinium enhancement (LGE) using cardiac magnetic resonance (CMR) characterizes myocardial disease and predicts an adverse cardiovascular (CV) prognosis. Myocardial abnormalities, are present in early chronic kidney disease (CKD). To date there are no data defining prevalence, pattern and clinical implications of LGE-CMR in CKD. METHODS Patients with pre-dialysis CKD (stage 2-5) attending specialist renal clinics at University Hospital Birmingham (UK) who underwent gadolinium enhanced CMR (1.5 T) between 2005 and 2017 were included. The patterns and presence (LGEpos) / absence (LGEneg) of LGE were assessed by two blinded observers. Association between LGE and CV outcomes were assessed. RESULTS In total, 159 patients received gadolinium (male 61%, mean age 55 years, mean left ventricular ejection fraction 69%, left ventricular hypertrophy 5%) with a median follow up period of 3.8 years [1.04-11.59]. LGEpos was present in 55 (34%) subjects; the patterns were: right ventricular insertion point n = 28 (51%), mid wall n = 18 (33%), sub-endocardial n = 5 (9%) and sub-epicardial n = 4 (7%). There were no differences in left ventricular structural or functional parameters with LGEpos. There were 12 adverse CV outcomes over follow up; 7 of 55 with LGEpos and 5 of 104 LGEneg. LGEpos was not predicted by age, gender, glomerular filtration rate or electrocardiographic abnormalities. CONCLUSIONS In a selected cohort of subjects with moderate CKD but low CV risk, LGE was present in approximately a third of patients. LGE was not associated with adverse CV outcomes. Further studies in high risk CKD cohorts are required to assess the role of LGE with multiplicative risk factors.

中文翻译：

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透析前慢性肾脏疾病的心肌特征：患病率，模式和结局的研究。

背景技术使用心脏磁共振（CMR）的晚期enhancement增强（LGE）表征心肌疾病并预测不良心血管（CV）预后。早期慢性肾脏疾病（CKD）中存在心肌异常。迄今为止，尚无数据可确定CKD中LGE-CMR的患病率，模式和临床意义。方法包括2005年至2017年间在英国伯明翰大学医院的肾脏专科诊所就诊的透析前CKD（2-5期）患者。两名盲人观察者评估了LGE的模式和存在（LGEpos）/不存在（LGEneg）。评估了LGE和CV结果之间的关联。结果总共159例患者接受了lin治疗（男性61％，平均年龄55岁，平均左心室射血分数69％，左室肥厚5％），中位随访期3.8年[1.04-11.59]。LGEpos存在于55个（34％）受试者中；模式为：右心室插入点n = 28（51％），中壁n = 18（33％），心内膜下n = 5（9％）和心外膜下n = 4（7％）。LGEpos的左心室结构或功能参数无差异。随访中有12例不利的简历结果；55个中的7个（带有LGEpos）和104个LGEneg的5个。LGEpos不能通过年龄，性别，肾小球滤过率或心电图异常来预测。结论在一组中度CKD但CV风险低的受试者中，约有三分之一的患者存在LGE。LGE与不良心血管结果无关。