title: Preload dependence of gated cardiac SPECT-derived ventricular volumes in hemodialysis patients.
abstract: BACKGROUND
  In hemodialysis (HD) patients, the intravascular volume expansion of the pre-HD state leads to a high preload. We aim to examine its effect on myocardial perfusion gated SPECT (MPGS)-derived left ventricular (LV) volumes.
  
  
  METHODS
  The study comprised 50 end-stage renal disease (ESRD) patients on HD with normal 2-day stress/rest MPGS performed for kidney transplantation risk assessment. Patients (pts) comprised 23 men/27 women, with mean age of 59.4 ± 7.1 years. The time elapsed from the last HD session in hours was calculated on both days, and patients were classified according to whether it was higher (group A: 19 pts), lower (group B: 27 pts), or equal (group C: 4 pts) on the stress vs the rest day. End-diastolic, end-systolic volumes (EDV, ESV), and left ventricular ejection fraction (LVEF) were determined using QGS™ software. Transient ischemic dilation (TID) ratios were derived from the nongated images using QPS™ software.
  
  
  RESULTS
  Volumes were significantly higher at stress in group A, at rest in group B, and similar in group C. TID ratios were significantly higher in group A vs groups B and C.
  
  
  CONCLUSIONS
  MPGS-derived ventricular volumes are preload dependent. The high preload of the pre-HD state may mimic ischemic TID if occurring on the stress day and create confusion if coinciding with the rest day.
authors.affiliation: Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain. ameliam.jimenez.sspa@juntadeandalucia.es
authors.forename: A
authors.initials: A
authors.lastname: Jimenez-Heffernan
authors.forename: E Sanchez
authors.initials: ES
authors.lastname: de Mora
authors.forename: C
authors.initials: C
authors.lastname: Salgado
authors.forename: J
authors.initials: J
authors.lastname: Lopez-Martin
authors.forename: C
authors.initials: C
authors.lastname: Ramos
authors.forename: E
authors.initials: E
authors.lastname: Rodriguez-Gomez
authors.forename: A
authors.initials: A
authors.lastname: Tobaruela
mesh_terms: D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D005189:False Positive Reactions; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology; D006435:Renal Dialysis; D015203:Reproducibility of Results; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000473:pathology; D016277:Ventricular Function, Left