Cardiovascular disease as result of chronic liver and chronic kidney disease Circulatory System
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age above 18 and below 65 years 2. Able to give informed consent And either: 3. CKD Stage 3b (eGFR> 30 and <44 ml/min) or 4. Compensated Cirrhotic Liver Disease proven radiologically or on biopsy
Exclusion criteria
Exclusion criteria: 1. Known cardiac disease- previous myocardial infarction, angina, arrhythmias including AF, cardiac surgery, myocarditis, pericarditis or other non-specified cardiac conditions 2. Taking beta blockers, calcium channel blockers or other rate/rhythm controlling medication 3. Unstable CKD ? AKI Stage 1 or more or other unplanned hospital admission relating to their kidney disease in the last 30 days 4. Unstable CLD ? Clinical decompensation or other unplanned hospital admission relating to their liver disease in the last 30 days 5. For liver patients ? previous Transjugular Portosystemic Shunt (TIPSS) insertion 6. Pregnant, breastfeeding or intending pregnancy 7. Unable to give consent or understand written information 8. Contraindications to MRI ? pacemaker, metallic fragments or implants, known claustrophobia 9. Inability to sustain 20 minutes of light exercise 10. Diabetes
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Myocardial perfusion as measured by Cardiac ASL MRI in ml/min/100g | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Cardiac strain and architecture as measured by PC-MRI 2. Thoracic bioreactance 3. AGE measurement 4. Pulse wave velocity 5. Non-invasive haemodynamics (BP, CO, SVR) 6. Baroreceptor sensitivity 7. Echocardiographic measure of ejection fraction, heart volumes 8. Serum markers of cardiac damage, endotoxin levels, renal, liver function, clotting, full blood count | — |
Countries
United Kingdom