Quantitative evaluation myocardium creatine in ESRD using MR CEST imaging: A Preliminary Study

Motivation: Patients with long-term chronic kidney disease experience disorders in myocardial energy metabolism disorders, further leading to cardiac function impairment. Goal(s): To evaluate myocardium creatine level using chemical exchange saturation transfer (CEST) technique and assess its correlation with left ventricular (LV) dysfunction in end-stage renal disease (ESRD) patients. Approach: Twenty-nine ESRD patients and 33 controls were included. Conventional cardiac MRI and CEST sequences were analyzed to calculate the correlations between myocardium creatine and LV function. Results: ESRD patients exhibited lower creatine CEST value, indicating myocardial energy metabolism failure. This finding was associated with reduced LV ejection fraction, highlighting its significance in LV dysfunction. Impact: Cardiac MRI CEST is a valuable technique for quantitatively measuring myocardial creatine levels, facilitating earlier diagnosis of myocardial energy metabolism failure, and guiding treatment in ESRD patients.