Impaired global myocardial flow dynamics despite normal left ventricular function and regional perfusion in chronic kidney disease: a quantitative analysis of clinical 82Rb PET/CT studies

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Kenji FukushimaFrank M Bengel

Abstract

Impaired global myocardial flow reserve (MFR) may be associated with increased risk for cardiac events and coronary artery disease progression. Chronic kidney disease (CKD) is also considered a risk factor for cardiovascular disease. We sought to investigate the effect of CKD on the myocardial microcirculation in patients referred for clinical (82)Rb PET/CT, who had normal left ventricular (LV) function and no flow-limiting coronary artery disease. Estimated glomerular filtration rate (eGFR) was available for 230 patients who had undergone rest and pharmacologic stress (82)Rb PET/CT for suspected coronary artery disease. CKD was defined as an eGFR less than 60 mL/min/1.73 m(2). After patients with hemodialysis, a renal transplant, abnormal regional perfusion (summed stress score > 4), or reduced LV function (LV ejection fraction < 45%) were excluded, 40 CKD patients remained. Those were compared with a control group without CKD, which was matched for age, sex, coronary risk factors, and systemic hemodynamics (n = 42). List-mode acquisition of PET enabled quantification of myocardial blood flow (MBF) and MFR using a previously validated retention model with correction for (82)Rb extraction. Rest MBF was normalized to rate-pressu...Continue Reading

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Citations

Mar 7, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Masanao NayaHiroyuki Tsutsui
Oct 21, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Matteo TebaldiGianluca Campo
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May 22, 2019·Current Cardiology Reports·Jamshid ShiraniVasken Dilsizian

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