Renal oxygen content is increased in healthy subjects after angiotensin-converting enzyme inhibition

Anna Stein, Silvia Goldmeier, Sarah Voltolini, Enio Setogutti, Carlos Feldman, Eduardo Figueiredo, Renato Eick, Maria Irigoyen, Katya Rigatto, Anna Stein, Silvia Goldmeier, Sarah Voltolini, Enio Setogutti, Carlos Feldman, Eduardo Figueiredo, Renato Eick, Maria Irigoyen, Katya Rigatto

Abstract

Objective: The association between renal hypoxia and the development of renal injury is well established. However, no adequate method currently exists to non-invasively measure functional changes in renal oxygenation in normal and injured patients.

Method: R2* quantification was performed using renal blood oxygen level-dependent properties. Five healthy normotensive women (50 ± 5.3 years) underwent magnetic resonance imaging in a 1.5T Signa Excite HDx scanner (GE Healthcare, Waukesha, WI). A multiple fast gradient-echo sequence was used to acquire R2*/T2* images (sixteen echoes from 2.1 ms/slice to 49.6 ms/slice in a single breath hold per location). The images were post-processed to generate R2* maps for quantification. Data were recorded before and at 30 minutes after the oral administration of an angiotensin II-converting enzyme inhibitor (captopril, 25 mg). The results were compared using an ANOVA for repeated measurements (mean + standard deviation) followed by the Tukey test. ClinicalTrials.gov: NCT01545479.

Results: A significant difference (p<0.001) in renal oxygenation (R2*) was observed in the cortex and medulla before and after captopril administration: right kidney, cortex = 11.08 ± 0.56 ms, medulla = 17.21 ± 1.47 ms and cortex = 10.30 ± 0.44 ms, medulla = 16.06 ± 1.74 ms, respectively; and left kidney, cortex= 11.79 ± 1.85 ms, medulla = 17.03 ± 0.88 ms and cortex = 10.89 ± 0.91 ms, medulla = 16.43 ± 1.49 ms, respectively.

Conclusions: This result suggests that the technique efficiently measured alterations in renal blood oxygenation after angiotensin II-converting enzyme inhibition and that it may provide a new strategy for identifying the early stages of renal disease and perhaps new therapeutic targets.

Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
An R2* map superimposed on the anatomic image of the 9th echo. The lowest R2* was set to 7 Hz (blue), and the maximum R2* was set to 23 Hz (red). The intermediate values range from green and yellow to orange according to the color scale on the left.

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