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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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Comparison of global left ventricular function between stress (open bars) and rest (shaded bars). a Left ventricular ejection fraction (LVEF). b Peak filling rate (PFR). c One-third of mean filling rate (1/3MFR). d Time to peak filling (TPF). Compared with global functional analysis at rest, LVEF and PFR significantly decreased in CAD and CAD + CKD groups after exercise stress or adenosine loading. CAD coronary artery disease, CKD chronic kidney disease. Data are expressed as mean ± SD. *p < 0.05
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Fig2: Comparison of global left ventricular function between stress (open bars) and rest (shaded bars). a Left ventricular ejection fraction (LVEF). b Peak filling rate (PFR). c One-third of mean filling rate (1/3MFR). d Time to peak filling (TPF). Compared with global functional analysis at rest, LVEF and PFR significantly decreased in CAD and CAD + CKD groups after exercise stress or adenosine loading. CAD coronary artery disease, CKD chronic kidney disease. Data are expressed as mean ± SD. *p < 0.05

Mentions: Both LVEF and PFR significantly decreased after exercise stress or adenosine loading compared with global LV function at rest in the CAD and CAD + CKD groups, whereas TPF tended to be prolonged in these groups without reaching statistical significance (Fig. 2).Fig. 2


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)

Comparison of global left ventricular function between stress (open bars) and rest (shaded bars). a Left ventricular ejection fraction (LVEF). b Peak filling rate (PFR). c One-third of mean filling rate (1/3MFR). d Time to peak filling (TPF). Compared with global functional analysis at rest, LVEF and PFR significantly decreased in CAD and CAD + CKD groups after exercise stress or adenosine loading. CAD coronary artery disease, CKD chronic kidney disease. Data are expressed as mean ± SD. *p < 0.05
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Comparison of global left ventricular function between stress (open bars) and rest (shaded bars). a Left ventricular ejection fraction (LVEF). b Peak filling rate (PFR). c One-third of mean filling rate (1/3MFR). d Time to peak filling (TPF). Compared with global functional analysis at rest, LVEF and PFR significantly decreased in CAD and CAD + CKD groups after exercise stress or adenosine loading. CAD coronary artery disease, CKD chronic kidney disease. Data are expressed as mean ± SD. *p < 0.05
Mentions: Both LVEF and PFR significantly decreased after exercise stress or adenosine loading compared with global LV function at rest in the CAD and CAD + CKD groups, whereas TPF tended to be prolonged in these groups without reaching statistical significance (Fig. 2).Fig. 2

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