Cardiomyopathies
Conditions
Brief summary
Chronic kidney disease (CKD) is associated with a high risk of death and morbidity due to cardiovascular disease. Much of this is caused by left ventricular disease characterised by abnormal muscle thickness and scaring. This process appears to start early in the course of CKD and causes heart failure and dangerous abnormal heart rhythms. Previous work suggests that the process may be reversible by kidney transplantation but almost all of the studies are small, retrospective and lack scientific rigour. Furthermore, they almost all use echocardiography, which is inaccurate in patients with CKD. The investigators plan to perform the first large, prospective, controlled, blind-analysed study using cardiac magnetic resonance imaging to determine whether CKD associated cardiomyopathy is reversed by kidney transplantation and if so, whether factors such as blood pressure and mediators of metabolic bone disease/fibrosis are important in effecting this change. Greater understanding of the mechanisms responsible for CKD associated cardiomyopathy could lead to future strategies and treatments to improve the high cardiovascular mortality associated with this condition.
Interventions
DIAGNOSTIC_TESTCardiac MRI
Cardiac Magnetic Resonance Imaging (Siemens Skyra 3T): will be performed using protocols and techniques already in use in our group. All CMR scan derived parameters will be analysed with the investigator blinded to treatment allocation as in previous studies.
Sponsors
University Hospital Birmingham NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients registered on the kidney transplant waiting list at the University Hospital Birmingham NHS Foundation Trust. 2. Ages over 18 years
Exclusion criteria
1. Non-standard anti-rejection treatment, post transplant. 2. Previous history of being unable to tolerate MRI scanner. 3. Contraindication to MRI - eg metal fragments in ey
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Left Ventricular Mass | One year. | Calculated by Cardiac MRI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Native Myocardial T1 Times. | One year. | Measured using T1 mapping techniques (MOLLI) |
| Blood Pressure | One year. | 24hr Ambulatory Blood pressure monitoring |
| Pulse Wave Analysis. | One Year | To calculate augmentation index as a marker of arterial stiffness. |
Countries
United Kingdom
Contacts
Primary ContactLuke Pickup, MBBS
Backup ContactCharles Ferro, MD
Outcome results
None listed