Quantification of myocardial perfusion reserve using dynamic SPECT images of patients with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disorders. The aim of this study was to examine whether the quantitatively measured myocardial blood flow (MBF) or myocardial perfusion reserve (MPR), calculated by dynamic single photon emission computed tomography (SPECT) analysis using a cardiac cadmium zinc telluride (CZT) gamma camera, was related to renal dysfunction in patients with normal myocardial perfusion imaging (MPI) findings.

METHODS: The study population consisted of 46 patients with CKD and 46 individuals without CKD (controls). Their MPR index was quantitatively measured using adenosine MPI with a cardiac CZT gamma camera. All assessments were with a single tissue compartment kinetic model. The K1 value was calculated on stress and at-rest images. To obtain the MPR index we divided K1 stress-by K1 at-rest values.

RESULTS: The at-rest K1 value was significantly higher and the MPR index was significantly lower in patients with CKD than those without CKD [CKD vs.

CONTROLS: at-rest K1 value, 0.21 (0.17-0.25) vs. 0.19 (0.16-0.22), p=0.040; MPR index, 1.86 (1.69-2.22) vs. 2.19 (1.93-2.41), p<0.001]. The stress K1 values were not significantly different.

CONCLUSION: The MPR index is significantly lower in CKD patients; this is considered as being mainly due to an increase in the at-rest K1 value.