Evaluation of left ventricular mechanical dyssynchrony with phase analysis in end-stage renal disease patients with normal gated SPECT-MPI

Abstract Introduction; the aim of this study was to employ phase analysis to diagnose left ventricular mechanical dyssynchrony (LVMD)in asymptomatic patients with diabetes mellitus type 2 and normal perfusion study to prevent diabetic cardiomyopathy.Methods & materials; Ninety-three consecutive patients with known type 2 diabetes and 81 age- and gender- matched patients without diabetes who were candidates for SPECT-MPI were considered as the control group. The presence of LVMD as an indicator of cardiomyopathy- was determined using phase analysis for each scan with quantitative gated SPECT (QGS) and corridor4DM (4DM) software. All outcomes such as phase bandwidth (PBW) and phase standard deviation (PSD) were compared between the two groups. Results; A total of 174 patients were included in the study. There were no statistically significant difference regarding demographic factors between the two groups (P>0.05). PBW showed statistically significant differences (increased in diabetics) between the control and diabetic patients (P < 0.05). Kruskal Wallis analysis revealed that as the duration of diabetes is prolonged, especially more than 15 years, the probability of LVMD is increased as well (p=0.021). Discussion; Fraction of asymptomatic diabetic patients with normal ejection fraction and gated SPECT MPI-especially those with prolonged diabetes- might have some degrees of LVMD. Phase analysis can detect this which in turn would prevent progress into heart failure.

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The prognostic value of left ventricular mechanical dyssynchrony using gated myocardial perfusion imaging in patients with end-stage renal disease

Journal of Nuclear Cardiology ◽

10.1007/s12350-014-9886-4 ◽

2014 ◽

Vol 21 (4) ◽

pp. 739-746 ◽

Cited By ~ 32

Author(s):

Himanshu Aggarwal ◽

Wael A. AlJaroudi ◽

Shikha Mehta ◽

Roslyn Mannon ◽

Jaekyeong Heo ◽

...

Keyword(s):

Myocardial Perfusion Imaging ◽

Myocardial Perfusion ◽

End Stage Renal Disease ◽

Prognostic Value ◽

Mechanical Dyssynchrony ◽

Left Ventricular ◽

Left Ventricular Mechanical Dyssynchrony ◽

Gated Myocardial Perfusion Imaging ◽

Stage Renal Disease ◽

End Stage

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Coronary microvascular dysfunction is associated with degree of anaemia in end‐stage renal disease

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02025-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ashwin Radhakrishnan ◽

Luke C. Pickup ◽

Anna M. Price ◽

Jonathan P. Law ◽

Kirsty C. McGee ◽

...

Keyword(s):

Confidence Interval ◽

Renal Disease ◽

Kidney Transplant ◽

End Stage Renal Disease ◽

Microvascular Dysfunction ◽

Left Ventricular ◽

Coronary Microvascular Dysfunction ◽

Transplant Candidates ◽

Stage Renal Disease ◽

End Stage

Abstract Background Coronary microvascular dysfunction (CMD) is common in end-stage renal disease (ESRD) and is an adverse prognostic marker. Coronary flow velocity reserve (CFVR) is a measure of coronary microvascular function and can be assessed using Doppler echocardiography. Reduced CFVR in ESRD has been attributed to factors such as diabetes, hypertension and left ventricular hypertrophy. The contributory role of other mediators important in the development of cardiovascular disease in ESRD has not been studied. The aim of this study was to examine the prevalence of CMD in a cohort of kidney transplant candidates and to look for associations of CMD with markers of anaemia, bone mineral metabolism and chronic inflammation. Methods Twenty-two kidney transplant candidates with ESRD were studied with myocardial contrast echocardiography, Doppler CFVR assessment and serum multiplex immunoassay analysis. Individuals with diabetes, uncontrolled hypertension or ischaemic heart disease were excluded. Results 7/22 subjects had CMD (defined as CFVR < 2). Demographic, laboratory and echocardiographic parameters and serum biomarkers were similar between subjects with and without CMD. Subjects with CMD had significantly lower haemoglobin than subjects without CMD (102 g/L ± 12 vs. 117 g/L ± 11, p = 0.008). There was a positive correlation between haemoglobin and CFVR (r = 0.7, p = 0.001). Similar results were seen for haematocrit. In regression analyses, haemoglobin was an independent predictor of CFVR (β = 0.041 95% confidence interval 0.012–0.071, p = 0.009) and of CFVR < 2 (odds ratio 0.85 95% confidence interval 0.74–0.98, p = 0.022). Conclusions Among kidney transplant candidates with ESRD, there is a high prevalence of CMD, despite the absence of traditional risk factors. Anaemia may be a potential driver of microvascular dysfunction in this population and requires further investigation.

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