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J Nucl Med. 2008; 49 (Supplement 1):127P
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Cardiovascular: Clinical Science

New' Applications and Findings for 'Old' Imaging Modalities

Myocardial perfusion falls during uncomplicated hemodialysis

Riemer H. J. A. Slart1, Rene A. Tio2, Casper F.M. Franssen3, Judith J Dasselaar3, Paul E de Jong3, Rudi A Dierckx1 and Jan Pruim1

1 Department of Nuclear Medicine & Molecular Imaging; 2 Cardiology; 3 Nephrology, University Medical Center Groningen, Groningen, Netherlands

505

Objectives: Previous studies have shown that cardiac output (CO) falls during hemodialysis (HD). We questioned whether the decrease in CO is primarily caused by hypovolemia-induced reduction of the filling volume of the left ventricle (LV) or by compromised myocardial contractility due to a diffuse or regional reduction in myocardial perfusion.

Methods: Gated 13N-ammonia Positron Emission Tomography (PET) was used to quantify changes in LV volume, LV function and myocardial perfusion in 7 chronic HD patients during a single HD session of 4 h duration. A total of 3 PET scans were performed: before the start of HD and 30 and 200 minutes into the HD session.

Results: HD sessions were uneventful. Total UF volume was 2831±960 ml. CO, LV end-diastolic, LV end-systolic volume and myocardial perfusion all decreased significantly during HD. Interestingly, myocardial perfusion had already significantly declined at 30 minutes into HD. The reduction in myocardial perfusion was diffuse in 5 patients and predominantly regional in 2 patients. There was a significant correlation between the change in myocardial perfusion and the change in CO at 200 min into the HD session (r=0.84; p=0.03). We found no significant correlation between the change in end-diastolic or end-systolic LV volume and the change in either CO or myocardial perfusion at 200 min.

Conclusions: Cardiac volumes and myocardial perfusion decrease significantly during HD in selected non-hypotension-prone HD patients with an uneventful cardiovascular history. Further studies to clarify the mechanism behind the link between the reduction in myocardial perfusion and cardiac output are necessary.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Slart, R. H. J. A.
Right arrow Articles by Pruim, J.
PubMed
Right arrow Articles by Slart, R. H. J. A.
Right arrow Articles by Pruim, J.