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Preload dependence of gated cardiac SPECT-derived ventricular volumes in hemodialysis patients

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

In hemodialysis (HD) patients, the intravascular volume expansion of the pre-HD state leads to a high preload. We aim to examine its effect on myocardial perfusion gated SPECT (MPGS)-derived left ventricular (LV) volumes.

Methods

The study comprised 50 end-stage renal disease (ESRD) patients on HD with normal 2-day stress/rest MPGS performed for kidney transplantation risk assessment. Patients (pts) comprised 23 men/27 women, with mean age of 59.4 ± 7.1 years. The time elapsed from the last HD session in hours was calculated on both days, and patients were classified according to whether it was higher (group A: 19 pts), lower (group B: 27 pts), or equal (group C: 4 pts) on the stress vs the rest day. End-diastolic, end-systolic volumes (EDV, ESV), and left ventricular ejection fraction (LVEF) were determined using QGS™ software. Transient ischemic dilation (TID) ratios were derived from the nongated images using QPS™ software.

Results

Volumes were significantly higher at stress in group A, at rest in group B, and similar in group C. TID ratios were significantly higher in group A vs groups B and C.

Conclusions

MPGS-derived ventricular volumes are preload dependent. The high preload of the pre-HD state may mimic ischemic TID if occurring on the stress day and create confusion if coinciding with the rest day.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain

    A Jimenez-Heffernan MD, PhD, FEBMN, FASNC, E. Sanchez de Mora MD, C. Salgado PharmD, J Lopez-Martin MD & C Ramos MD, PhD

  2. Department of Nephrology, Hospital Juan Ramon Jimenez, Huelva, Spain

    E Rodriguez-Gomez MD

  3. Department of Cardiology, Hospital Juan Ramon Jimenez, Huelva, Spain

    A Tobaruela MD

Authors
  1. A Jimenez-Heffernan MD, PhD, FEBMN, FASNC
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  2. E. Sanchez de Mora MD
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  3. C. Salgado PharmD
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  4. J Lopez-Martin MD
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Corresponding author

Correspondence to A Jimenez-Heffernan MD, PhD, FEBMN, FASNC.

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Jimenez-Heffernan, A., de Mora, E.S., Salgado, C. et al. Preload dependence of gated cardiac SPECT-derived ventricular volumes in hemodialysis patients. J. Nucl. Cardiol. 19, 743–751 (2012). https://doi.org/10.1007/s12350-012-9560-7

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  • DOI: https://doi.org/10.1007/s12350-012-9560-7

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