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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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Correlation between peak filling rate (PFR) and estimated glomerular filtration rate (eGFR) (a), summed difference score (SDS) (b). The eGFR correlated significantly and positively with PFR at rest in all 136 patients (a) and a weak inverse correlation between SDS and PFR after stress was nevertheless significant (b). EDV end-diastolic volume
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Fig3: Correlation between peak filling rate (PFR) and estimated glomerular filtration rate (eGFR) (a), summed difference score (SDS) (b). The eGFR correlated significantly and positively with PFR at rest in all 136 patients (a) and a weak inverse correlation between SDS and PFR after stress was nevertheless significant (b). EDV end-diastolic volume

Mentions: The eGFR correlated significantly and positively with PFR at rest in all 136 patients (Fig. 3a) and a weak inverse correlation between SDS and PFR was nevertheless significant (Fig. 3b). We analyzed which clinical and scintigraphic parameters were independently associated with PFR after stress by including age, eGFR, SDS, HR, LVMI, hemoglobin, and LVEF in a multivariate stepwise regression model. The results independently associated age, eGFR, and SDS with PFR, but not LVMI, hemoglobin and LVEF (Table 4).Fig. 3


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)

Correlation between peak filling rate (PFR) and estimated glomerular filtration rate (eGFR) (a), summed difference score (SDS) (b). The eGFR correlated significantly and positively with PFR at rest in all 136 patients (a) and a weak inverse correlation between SDS and PFR after stress was nevertheless significant (b). EDV end-diastolic volume
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: Correlation between peak filling rate (PFR) and estimated glomerular filtration rate (eGFR) (a), summed difference score (SDS) (b). The eGFR correlated significantly and positively with PFR at rest in all 136 patients (a) and a weak inverse correlation between SDS and PFR after stress was nevertheless significant (b). EDV end-diastolic volume
Mentions: The eGFR correlated significantly and positively with PFR at rest in all 136 patients (Fig. 3a) and a weak inverse correlation between SDS and PFR was nevertheless significant (Fig. 3b). We analyzed which clinical and scintigraphic parameters were independently associated with PFR after stress by including age, eGFR, SDS, HR, LVMI, hemoglobin, and LVEF in a multivariate stepwise regression model. The results independently associated age, eGFR, and SDS with PFR, but not LVMI, hemoglobin and LVEF (Table 4).Fig. 3

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