Left Ventricular Myocardial Fibrosis in early CKD
Research type
Research Study
Full title
Onset and Functional Consequences of Left Ventricular Myocardial Fibrosis in Early Stage Chronic Kidney Disease.
IRAS ID
181020
Contact name
Richard Steeds
Contact email
Sponsor organisation
R&D Department
Duration of Study in the UK
2 years, 11 months, 27 days
Research summary
Chronic kidney disease (CKD) is common, affecting 1 in 10 adults in the UK. Early CKD is associated with a high risk of heart and vascular disease which exceeds the risk of developing advanced CKD requiring dialysis. In a study of subjects over 65 years old with mild kidney impairment, about half of all patients that died over a 10 year period did so as a result of a heart event compared to the small percentage (5%) who progressed to advanced CKD. The majority of heart deaths are not a result of a heart attack (as in the general population) but occur suddenly or from heart failure. Studies taking invasive biopsy samples of heart muscle under x-ray guidance from patients with advanced CKD have shown an increase in fibrous tissue is common. At present, the onset and changes associated with heart disease in early CKD have been little studied but preliminary data from the Birmingham Cardio-Renal Group (www.birmingham.ac.uk/bcrg) using MRI scans have shown an increase in fibrous scar within the heart muscle. This may cause the heart to become stiff and to contract poorly. We now have a new, improved, non-invasive method of detecting fibrous scar in the heart using MRI. This technique, known as T1 mapping, takes pictures of the heart without X-rays, intravenous contrast, or need for biopsy. The aims of this study are to: i) establish whether fibrous scar within the heart increases as kidney function declines; ii) whether an increase in fibrous scar is associated with a decrease in heart function and exercise capacity, iii) discover blood tests which might help identify patients at higher risk of having fibrous scar allowing more selective use of MRI. Understanding this will allow development of treatments which could potentially reduce heart related deaths in these patients.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
15/EM/0280
Date of REC Opinion
18 Aug 2015
REC opinion
Further Information Favourable Opinion