The purpose of our study was to assessthe utility of myocardial native T1-mapping obtained at cardiac magnetic resonance (CMR) to search for myocardial fibrosis in paediatric patients with chronic nephropathy, who cannot be administered gadolinium contrastto acquire the standard delayed enhancement sequences. Therefore, myocardial native T1 mapping may act as an early marker of cardiac involvement in these patients.

17paediatric patients, including 7 males and 10 females (age range 8-34 years, mean 16 years), were prospectively selected. The patients were divided into two subgroups: 7 nephropathic subjects; 10 normal controls. All patients underwent 1.5 T CMR comprising native T1-mapping MOLLI sequences, which consisted of one 4-chamber view and three short-axis slices (basal, midventricular, and apical). These sequences are equipped with a motion correction (MOCO) algorithm in order to reduce respiratory artefacts, which are frequently found in children. Image analysis: a global myocardial native T1...

Although within the commonly accepted normal interval, myocardial native T1 values were in the upper normal range and slightly higher in nephropathic patients (Fig. 2&Fig. 3) compared to the normal controls. In detail, the mean value was 1023,4 ms (SD 22,5) in nephropathic subjects versus 999,0 ms (SD 10,8) in normal individuals, with a statistically significant difference between the two groups (p 0.008, CI 95% -41,4 to -7,4). No other statistically significant differences were found concerning the other standard CMR parameters, not even for left...

Borderline upper normal native T1 mapping values may help identify initial myocardial fibrosis in paediatric patients with chronic nephropathy,providing a potential additional tool to stratify their cardiac involvement and cardiovascular risk.

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