Author + information
- Nilay Kumar,
- Himanshu Aggarwal,
- Shikha Mehta,
- Roslyn Mannon,
- Jaekyeong Heo,
- Ami Iskandrian and
- Fadi Hage
Gated SPECT myocardial perfusion imaging (MPI) provides a opportunity to assess ejection fraction (EF), myocardial perfusion and LV dyssynchrony (LVD, by phase analysis). EF and perfusion are predictors of outcome in end stage renal disease (ESRD) but risk is high even with normal findings. We hypothesized that LVD is an independent predictor of outcome.
Gated MPI were processed to derive phase bandwidth (BW) and standard deviation (SD) in ESRD patients who underwent MPI. All-cause mortality data was prospectively collected and verified against the social security death index database.
Study population consisted of 836 ESRD patients. EF was 55±1%, and 41% had abnormal perfusion. Cohort was prospectively followed for 5.0±2.1 years during which time 293 (35%) died. The phase BW was 68.9±1.5 and SD was 24.1±0.5. The BW (73.6±2.6 vs. 66.4±1.8, P =.03) and SD (25.3±0.8 vs. 23.4±0.6, P =.05) were greater in patients who died than those who survived. Kaplan-Meier analysis showed patients with BW (Figure 1) or SD above the median had worse survival. In patients with LVEF≥35%, a wide BW continued to be associated with increased mortality (log-rank P =.02). In Cox proportional model for mortality adjusted for age, gender, DM, HTN, LVEF < 35% and abnormal perfusion, a wide BW (>56) was associated with worse outcome (HR 1.29 95% Cl 1.01-1.65, P=0.04).
LVD measured by phase analysis of MPI provides incremental prognostic value to myocardial perfusion and EF in ESRD.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Nuclear Imaging: Looking Beyond Perfusion
Abstract Category: 21. Imaging: Nuclear
Presentation Number: 1183-359
- 2013 American College of Cardiology Foundation