T(1) and T(2) 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.