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Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

This study aimed to investigate whether indices of left ventricular (LV) dyssynchrony by gated myocardial perfusion SPECT (GMPS) could be useful to predict prognosis in chronic kidney disease (CKD) patients with normal perfusion defect scores.

Methods

One hundred and sixty-seven CKD patients with normal perfusion defect scores on adenosine-stress 201Tl GMPS and no previous history of overt heart diseases were enrolled. Phase standard deviation (PSD) and bandwidth (BW) were automatically calculated from GMPS. The major adverse cardiac events (MACEs) for a mean of 560 days were defined as sudden cardiac death, fatal arrhythmias, and acute coronary syndrome requiring urgent coronary revascularization. Patients were divided into two groups according to the presence or absence of MACEs.

Results

The MACEs occurred in 12 patients (7.1%). Patients who experienced MACEs showed significantly higher PSD and wider BW than those who did not. In the Kaplan-Meier event-free survival analysis, cardiac event rate was significantly higher in the high-PSD and wide-BW group (n = 81) than in the low-PSD and narrow-BW group (n = 71) (P = .002). The multivariate regression analysis revealed that the PSD was associated with MACEs (odds ratio 1.33, 95% confidence interval 1.05-1.69, P = .01).

Conclusion

The LV dyssynchrony indices from GMPS may be novel prognostic predictors in CKD patients with normal perfusion defect scores.

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Abbreviations

BW:

Bandwidth

CKD:

Chronic kidney disease

EDV:

End-diastolic volume

eGFR:

Estimated glomerular filtration rate

ESV:

End-systolic volume

GMPS:

Gated myocardial perfusion SPECT

LVEF:

Left ventricular ejection fraction

MACE:

Major adverse cardiac event

PSD:

Phase standard deviation

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Acknowledgements

The authors thank Toshiro Fujita and Shinji Abe, radiological technicians, for technical assistance in the SPECT examination.

Disclosure

The authors declare that they have no conflict of interest and financial disclosures.

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Authors and Affiliations

  1. Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Hiroaki Mori MD, Satoshi Isobe MD, PhD, Susumu Suzuki MD, PhD, Kazumasa Unno MD, PhD, Ryota Morimoto MD, Naoaki Kano MD, Takahiro Okumura MD, PhD & Toyoaki Murohara MD, PhD

  2. Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Susumu Suzuki MD, PhD, Ryota Morimoto MD & Yoshinari Yasuda MD, PhD

  3. Division of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Yoshinari Yasuda MD, PhD

  4. Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Katsuhiko Kato MD, PhD

Authors
  1. Hiroaki Mori MD
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  2. Satoshi Isobe MD, PhD
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  3. Susumu Suzuki MD, PhD
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  4. Kazumasa Unno MD, PhD
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  7. Takahiro Okumura MD, PhD
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Corresponding author

Correspondence to Satoshi Isobe MD, PhD.

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Mori, H., Isobe, S., Suzuki, S. et al. Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores. J. Nucl. Cardiol. 26, 288–297 (2019). https://doi.org/10.1007/s12350-017-0889-9

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  • DOI: https://doi.org/10.1007/s12350-017-0889-9

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