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

A Jimenez-Heffernan1, E Sanchez de Mora, C Salgado

  • 1Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain. ameliam.jimenez.sspa@juntadeandalucia.es

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|April 25, 2012
PubMed

Insights

Hemodialysis (HD) patients exhibit preload-dependent left ventricular (LV) volumes on myocardial perfusion gated SPECT (MPGS). High preload before HD can mimic or confuse transient ischemic dilation (TID) findings.

Area of Science:

  • Cardiology
  • Nephrology
  • Nuclear Medicine

Background:

  • Patients undergoing hemodialysis (HD) often present with intravascular volume expansion, leading to elevated preload.
  • This elevated preload in the pre-HD state can influence cardiac imaging parameters.

Purpose of the Study:

  • To investigate the impact of pre-hemodialysis intravascular volume expansion on left ventricular (LV) volumes derived from myocardial perfusion gated SPECT (MPGS).

Main Methods:

  • Fifty end-stage renal disease (ESRD) patients on HD underwent a 2-day stress/rest MPGS.
  • Patients were grouped based on the time elapsed since their last HD session before stress and rest scans.
  • LV volumes (EDV, ESV, LVEF) and transient ischemic dilation (TID) ratios were calculated.

Main Results:

  • LV volumes were significantly higher during the stress phase in patients with longer intervals since HD (Group A).
  • Conversely, volumes were higher during the rest phase in patients with shorter intervals (Group B).
  • TID ratios were significantly elevated in Group A compared to Groups B and C.

Conclusions:

  • Myocardial perfusion gated SPECT (MPGS)-derived left ventricular (LV) volumes are significantly influenced by preload.
  • The high preload present before hemodialysis can lead to findings that mimic ischemic transient ischemic dilation (TID) or cause misinterpretation.
Abstract

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