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Impaired renal function is a major determinant of left ventricular diastolic dysfunction: assessment by stress myocardial perfusion imaging.

Sato W, Kosaka T, Koyama T, Ishida M, Iino K, Watanabe H, Ito H - Ann Nucl Med (2013)

Bottom Line: The PFR was significantly impaired after stress in the CKD and CAD + CKD groups compared with controls (p < 0.001 for both).Multivariate stepwise regression analysis independently associated eGFR with PFR (β coefficient = 0.260, p = 0.002).Our data suggest that impaired renal function is a significant determinant of LV diastolic dysfunction in patients with suspected CAD.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan, wsato@med.akita-u.ac.jp.

ABSTRACT

Objective: Relationships between myocardial scintigraphic parameters and renal function have not been fully determined. We investigated correlations between estimated glomerular filtration rate (eGFR) and left ventricular (LV) diastolic function using stress electrocardiographic (ECG)-gated myocardial single photon emission computed tomography (SPECT).

Methods: We enrolled 136 consecutive patients with suspected coronary artery disease (CAD) who were assessed using technetium-99m stress ECG-gated myocardial SPECT. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score, summed rest score and summed difference score (SDS). The parameters for assessing LV diastolic function were peak filling rate (PFR), 1/3 mean filling rate and time to peak filling. The CAD was defined as SDS ≥2. Chronic kidney disease (CKD) was defined as eGFR <60 mL/min/1.73 m(2). Patients were assigned to the following four groups (no CAD/no CKD: control group, n = 68; CAD/no CKD: CAD group, n = 24; no CAD/CKD: CKD group, n = 34; CAD/CKD: CAD + CKD group, n = 10).

Results: The PFR was significantly impaired after stress in the CKD and CAD + CKD groups compared with controls (p < 0.001 for both). Furthermore, PFR at rest positively correlated with eGFR (r = 0.29, p < 0.001) and inversely correlated with SDS (r = -0.18, p < 0.05). Multivariate stepwise regression analysis independently associated eGFR with PFR (β coefficient = 0.260, p = 0.002).

Conclusions: Our data suggest that impaired renal function is a significant determinant of LV diastolic dysfunction in patients with suspected CAD.

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Flow chart of study population. CAD coronary artery disease, CKD chronic kidney disease, LVEF left ventricular ejection fraction, OMI old myocardial infarction
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Fig1: Flow chart of study population. CAD coronary artery disease, CKD chronic kidney disease, LVEF left ventricular ejection fraction, OMI old myocardial infarction

Mentions: This prospective study included 387 consecutive patients with suspected CAD who had undergone stress ECG-gated myocardial SPECT at Akita University Hospital between July 2010 and March 2012. Patients older than 80 years of age were excluded. Moreover, we did not enroll patients with atrial fibrillation, major cardiovascular complications involving old myocardial infarction, idiopathic cardiomyopathy, significant valvular heart disease, depressed LV ejection fraction (EF) (<50 %) and hemodialysis. Patients with post-examination LV end-systolic volume (ESV) of <15 mL determined by QGS were also excluded to rule out patients with small hearts [10]. The Ethics Committees of Akita University Graduate School of Medicine approved the study protocol and 136 eligible patients provided written informed consent to participate in the study (Fig. 1).Fig. 1


Impaired renal function is a major determinant of left ventricular diastolic dysfunction: assessment by stress myocardial perfusion imaging.

Sato W, Kosaka T, Koyama T, Ishida M, Iino K, Watanabe H, Ito H - Ann Nucl Med (2013)

Flow chart of study population. CAD coronary artery disease, CKD chronic kidney disease, LVEF left ventricular ejection fraction, OMI old myocardial infarction
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3824632&req=5

Fig1: Flow chart of study population. CAD coronary artery disease, CKD chronic kidney disease, LVEF left ventricular ejection fraction, OMI old myocardial infarction
Mentions: This prospective study included 387 consecutive patients with suspected CAD who had undergone stress ECG-gated myocardial SPECT at Akita University Hospital between July 2010 and March 2012. Patients older than 80 years of age were excluded. Moreover, we did not enroll patients with atrial fibrillation, major cardiovascular complications involving old myocardial infarction, idiopathic cardiomyopathy, significant valvular heart disease, depressed LV ejection fraction (EF) (<50 %) and hemodialysis. Patients with post-examination LV end-systolic volume (ESV) of <15 mL determined by QGS were also excluded to rule out patients with small hearts [10]. The Ethics Committees of Akita University Graduate School of Medicine approved the study protocol and 136 eligible patients provided written informed consent to participate in the study (Fig. 1).Fig. 1

Bottom Line: The PFR was significantly impaired after stress in the CKD and CAD + CKD groups compared with controls (p < 0.001 for both).Multivariate stepwise regression analysis independently associated eGFR with PFR (β coefficient = 0.260, p = 0.002).Our data suggest that impaired renal function is a significant determinant of LV diastolic dysfunction in patients with suspected CAD.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan, wsato@med.akita-u.ac.jp.

ABSTRACT

Objective: Relationships between myocardial scintigraphic parameters and renal function have not been fully determined. We investigated correlations between estimated glomerular filtration rate (eGFR) and left ventricular (LV) diastolic function using stress electrocardiographic (ECG)-gated myocardial single photon emission computed tomography (SPECT).

Methods: We enrolled 136 consecutive patients with suspected coronary artery disease (CAD) who were assessed using technetium-99m stress ECG-gated myocardial SPECT. We evaluated SPECT images using 17-segment defect scores graded on a 5-point scale, summed stress score, summed rest score and summed difference score (SDS). The parameters for assessing LV diastolic function were peak filling rate (PFR), 1/3 mean filling rate and time to peak filling. The CAD was defined as SDS ≥2. Chronic kidney disease (CKD) was defined as eGFR <60 mL/min/1.73 m(2). Patients were assigned to the following four groups (no CAD/no CKD: control group, n = 68; CAD/no CKD: CAD group, n = 24; no CAD/CKD: CKD group, n = 34; CAD/CKD: CAD + CKD group, n = 10).

Results: The PFR was significantly impaired after stress in the CKD and CAD + CKD groups compared with controls (p < 0.001 for both). Furthermore, PFR at rest positively correlated with eGFR (r = 0.29, p < 0.001) and inversely correlated with SDS (r = -0.18, p < 0.05). Multivariate stepwise regression analysis independently associated eGFR with PFR (β coefficient = 0.260, p = 0.002).

Conclusions: Our data suggest that impaired renal function is a significant determinant of LV diastolic dysfunction in patients with suspected CAD.

Show MeSH
Related in: MedlinePlus