Short-Term Follow-Up of Myocardial Changes After Kidney Transplantation by Cardiac Magnetic Resonance Using Native T1 Mapping

Abstract

Introduction Kidney transplantation improves cardiovascular outcomes in patients with reduced myocardial functionand heart failure. However,detecting early structuralmyocardial changes remains challenging.Cardiac magnetic resonance (CMR) T1 mapping is a non-invasive imaging technique that allows early detectionof diffusemyocardialtissue injury arba damage, which is valuable in assessing early cardiac changes in kidney transplantrecipients. Aim of the study To evaluate the significance of CMR native T1 mapping in detecting and monitoring early myocardial changesduring short-term follow-up after kidney transplantation. Materials and methods This retrospective study included 22 patients who underwent CMR using a 3 Tesla scanner baseline at the beginning of transplantationand three months later. Diastolic native T1 mapping was performedat both time points. Measurements were taken in the interventricular septum at three myocardiallevels: basal, middle, and apical, using short-axis slices. Identical 1cm2 regions of interest (ROI) were placed in the same locationsat both time points to ensure measurement consistency. Statistical analysis included paired t-test,repeated-measures ANOVA, and intraclass correlation coefficients(ICC) to evaluate myocardial changes over time and assess the reliability of T1 mapping measurement consistency. Data analysis was performed using SPSS Statistics 26.0. Results The mean time interval between the two T1 mappingscans was 83 days. T1 values in the basal myocardial segment showeda slight decrease (from 1278.09ms to 1262.04ms),but this change was not statistically significant (p=0.122). A significantreduction in T1 values was observed in the middle myocardial segment, with a mean decrease from 1285ms (SD=48.654)to 1250.58ms (SD=34.363),p<0.001. This reduction was associatedwith a large effect size (Cohen’sd=0.919, ICC=0.745,p=0.001), suggesting notable myocardialremodeling. The apical segment also showed a moderate reduction, with a mean from 1286ms (SD=69.511)to 1244ms (SD=62.470), with statistical significance (Cohen’s d=0.714, ICC=0.747, p=0.003), indicating myocardial adaptation. Conclusions A short-term follow-up study of patients after kidney transplantation demonstrates an interval decrease in native T1 mapping values in the middle and apical segments, indicatingpotentially reversiblediffusemyocardialtissue injury arba damage. These findings support T1 mappingas a valuable imaging technique for monitoring myocardial changes in kidney transplantrecipients.