Prognostic significance of myocardial flow reserve in the patients with dialysis dependent end stage renal disease evaluated with pharmacological stress N13-ammonia PET

• Published in: The Journal of nuclear medicine (1978) Vol. 59; p. 439
• Main Author: Ohshima, Satoru
• Format: Journal Article
• Language: English
• Published: New York Society of Nuclear Medicine 01-05-2018
• Subjects: Ammonia; Cardiovascular diseases; Coronary artery disease; Death; Dialysis; Heart diseases; Ischemia; Kidney diseases; Mortality; Multivariate analysis; Pharmacology
• ISSN: 0161-5505; 1535-5667

Purpose: We investigated the prognostic value of myocardial flow reserve (MFR) evaluated with pharmacological stress N13-ammonia PET in the patients with dialysis dependent end stage renal disease (dd-ESRD). Methods: 438 consecutive dd-ESRD patients (median age 68 years), who were performed ammonia PET for the evaluation of suspected ischemic heart disease, were enrolled in this study. Patients were divided into two groups based on the median value of MFR (2.0). The incidence of all-cause death, cardiovascular death, and MACE were compared between two groups. Results: Incidence of all-cause death (log rank p<0.001, HR=3.63 (2.01-7.02)), cardiovascular death (log rank p<0.001, HR=2.68 (1.69-3.34)), and MACE (log rank p<0.001 , HR= 3.10 (1,37-7.89)) were significant higher in low CFR group than in high CFR group. Uni and multivariate analysis revealed that low CFR was the independent predictor of all cause death (HR=3.59 (1.85-7.38)), cardiovascular death (HR=2.44 (1.46-4.19)), and MACE (HR=4.03 (1.59-11.31)). Conclusions: Low MFR could predict poor prognosis in the dd-ESRD patients.