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

• Published in: Journal of nuclear cardiology 2012-08, Vol.19 (4), p.743-751
• Main Authors: Jimenez-Heffernan, A, de Mora, E. Sanchez, Salgado, C., Lopez-Martin, J, Ramos, C, Rodriguez-Gomez, E, Tobaruela, A
• Format: Article
• Language: English
• Subjects: Aged; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography - methods; Cardiology; Coronary Angiography - methods; False Positive Reactions; Female; Gated Blood-Pool Imaging - methods; Humans; Image Processing, Computer-Assisted; Imaging; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Ischemia - pathology; Nuclear Medicine; Original Article; Radiology; Renal Dialysis; Reproducibility of Results; Software; Tomography, Emission-Computed, Single-Photon - methods; Ventricular Dysfunction, Left - pathology; Ventricular Function, Left
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-012-9560-7

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.