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Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores.

Prognostic value of left ventricular dyssynchrony evaluated by gated myocardial perfusion imaging in patients with chronic kidney disease and normal perfusion defect scores.
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Mori H, Isobe S, Suzuki S, Unno K, Morimoto R, Kano N, Okumura T, Yasuda Y, Kato K, Murohara T,


Mori H, Isobe S, Suzuki S, Unno K, Morimoto R, Kano N, Okumura T, Yasuda Y, Kato K, Murohara T, (click to view)

Mori H, Isobe S, Suzuki S, Unno K, Morimoto R, Kano N, Okumura T, Yasuda Y, Kato K, Murohara T,

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Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 2017 04 21() doi 10.1007/s12350-017-0889-9
Abstract
BACKGROUND
This study aimed to investigate whether indices of left ventricular (LV) dyssynchrony by gated myocardial perfusion SPECT (GMPS) could be useful to predict prognosis in chronic kidney disease (CKD) patients with normal perfusion defect scores.

METHODS
One hundred and sixty-seven CKD patients with normal perfusion defect scores on adenosine-stress (201)Tl GMPS and no previous history of overt heart diseases were enrolled. Phase standard deviation (PSD) and bandwidth (BW) were automatically calculated from GMPS. The major adverse cardiac events (MACEs) for a mean of 560 days were defined as sudden cardiac death, fatal arrhythmias, and acute coronary syndrome requiring urgent coronary revascularization. Patients were divided into two groups according to the presence or absence of MACEs.

RESULTS
The MACEs occurred in 12 patients (7.1%). Patients who experienced MACEs showed significantly higher PSD and wider BW than those who did not. In the Kaplan-Meier event-free survival analysis, cardiac event rate was significantly higher in the high-PSD and wide-BW group (n = 81) than in the low-PSD and narrow-BW group (n = 71) (P = .002). The multivariate regression analysis revealed that the PSD was associated with MACEs (odds ratio 1.33, 95% confidence interval 1.05-1.69, P = .01).

CONCLUSION
The LV dyssynchrony indices from GMPS may be novel prognostic predictors in CKD patients with normal perfusion defect scores.

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