T1 and T2 Mapping in Uremic Cardiomyopathy: An Update

Uremic cardiomyopathy (UC) is the cardiac remodelling that occurs in patients with chronic kidney disease (CKD). It is characterised by a left ventricular (LV) hypertrophy phenotype, diastolic dysfunction and generally preserved LV ejection fraction. UC has a major role mediating the increased rate of cardiovascular events, especially heart failure related, observed in patients with CKD. Recently, the use of T-1 and T-2 mapping techniques on cardiac MRI has expanded the ability to characterise cardiac involvement in CKD. Native T-1 mapping effectively tracks the progression of interstitial fibrosis in UC, whereas T-2 mapping analysis suggests the contribution of myocardial oedema, at least in a subgroup of patients. Both T-1 and T-2 increased values were related to worsening clinical status, myocardial injury and B-type natriuretic peptide release. Studies investigating the prognostic relevance and histology validation of mapping techniques in CKD are awaited.