Myocardial fatty acid imaging identifies a group of hemodialysis patients at high risk for cardiac death after coronary revascularization.
We prospectively evaluated if impaired myocardial fatty acid metabolism is involved in cardiac death after revascularization by percutaneous coronary artery intervention in dialysis patients. A cohort of hemodialysis patients was assessed by dual single-photon emission computed tomography using the radioiodinated fatty acid analogue BMIPP and radiolabeled thallium chloride. Tomography was done within one month before the first coronary intervention and at the last follow-up angiography at which neither restenosis nor de novo lesions were detected. Radiolabel uptake on tomography images was graded in segments and calculated as summed BMIPP or thallium scores. Among the 90 hemodialysis patients in the study, 19 died of cardiac events. Multivariate Cox hazard analysis found a significant association of cardiac death with the BMIPP summed scores at the last follow-up angiography. Kaplan-Meier analysis showed the cardiac death-free survival rates at 3 years of follow-up were significantly higher in patients with lower BMIPP summed scores. These results suggest that myocardial fatty acid imaging may be a useful test to identify high risk groups of cardiac death in hemodialysis patients.
Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan. mnishimura@tea.ocn.ne.jp
Masato
M
Nishimura
Toshiko
T
Tokoro
Masasya
M
Nishida
Tetsuya
T
Hashimoto
Hiroyuki
H
Kobayashi
Satoru
S
Yamazaki
Ryo
R
Imai
Koji
K
Okino
Hakuo
H
Takahashi
Toshihiko
T
Ono
D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D016757:Death, Sudden, Cardiac; D005227:Fatty Acids; D005260:Female; D006321:Heart; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis; D018570:Risk Assessment; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid