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

Author:
Jimenez-Heffernan, A.  Sanchez de Mora, E.  Salgado, C.  Lopez-Martin, J.  Ramos, C.  Rodriguez-Gomez, E.  Tobaruela, A.  


Journal:
JOURNAL OF NUCLEAR CARDIOLOGY


Issue Date:
2012


Abstract(summary):

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. 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 +/- A 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 (TM) software. Transient ischemic dilation (TID) ratios were derived from the nongated images using QPS (TM) software. 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. 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.


Page:
743---751


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