title: Myocardial SPECT Images in Incident Hemodialysis Patients Without Ischemic Heart Disease.
abstract: Cardiovascular disease is the leading cause of death in dialysis patients and is significantly associated with poor survival in incident dialysis patients. However, little is known about the pathogenesis of cardiovascular disease in these populations. (123) I-15-(p-iodophenyl)-3(R,S)- methylpentadecanoic acid (BMIPP) imaging is useful for detection of ischemic heart disease. We examined imaging characteristics to identify potential pathologies of cardiac disease, other than ischemic heart disease. The subjects were 42 incident dialysis patients without histories of ischemic heart disease such as acute coronary syndrome. All the patients underwent BMIPP imaging in addition to a screening examination. Patients with positive findings in BMIPP imaging underwent myocardial perfusion imaging within 2 weeks after BMIPP imaging to evaluate the possibility of ischemic heart disease. Twenty-two patients were BMIPP-positive and 10 of these patients had negative findings on perfusion imaging and were defined as mismatch cases. Compared with patients who were BMIPP- and perfusion-positive, the mismatch cases had higher parathyroid hormone (PTH), serum albumin, and alkaline phosphatase levels. The mismatch cases also formed the largest proportion in the highest PTH tertile. A histologic examination of a mismatch case with no stenotic lesions in the coronary artery revealed the presence of cardiac hypertrophy and fibrosis. These findings suggest that a perfusion-metabolism mismatch may be present in incident dialysis patients without a history of ischemic heart disease. This mismatch is associated with PTH, which suggests potential involvement of uremic cardiomyopathy in the pathology of cardiac disease in these patients.
authors.affiliation: Division of Nephrology, Showa University, Tokyo, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Koyama-Nakamura
authors.affiliation: Division of Nephrology, Showa University, Tokyo, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Mizobuchi
authors.affiliation: Cardiology, Department of Internal Medicine, Showa University, Tokyo, Japan.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Division of Nephrology, Showa University, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ogata
authors.affiliation: Department of Medicine, Division of Nephrology, Showa University Fujigaoka Hospital, Yokohama, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Koiwa
authors.affiliation: Division of Nephrology, Showa University, Tokyo, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
authors.affiliation: Cardiology, Department of Internal Medicine, Showa University, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Akutsu
authors.affiliation: Division of Nephrology, Showa University, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Shibata
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D005227:Fatty Acids; D005260:Female; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015415:Biomarkers; D005227:Fatty Acids; D007462:Iodobenzenes; D010281:Parathyroid Hormone; D012709:Serum Albumin; C049338:iodofiltic acid; D000469:Alkaline Phosphatase
keywords: 123I-15-(p-iodophenyl)-3(R; Heart failure; Left ventricular; Parathyroid hormone; S)- methylpentadecanoic acid; Uremic cardiomyopathy