Prognostic value of stress myocardial perfusion imaging using adenosine triphosphate at the beginning of haemodialysis treatment in patients with end-stage renal disease

Abstract

Normal myocardial perfusion imaging by stress thallium-201 SPECT using high-dose ATP performed within 1 month after the beginning of haemodialysis treatment is a powerful predictor of cardiac event-free survival in patients with ESRD.

Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study

“…4,12,21 Indeed, a diagnosis of CAD might be problematic in the setting of CKD, since such patients frequently do not experience ischemic symptoms, elevated cardiac biomarkers, and ECG changes. 3,4,22 Although coronary angiography has been considered the gold standard for detecting CAD, contrast media-induced nephropathy or cholesterol microembolization has emerged as serious problems.…”

Pathophysiology and Therapeutic Potential of Purinergic Signaling

“…Eicosapentaenoic acid, one of the active components in fish oil that has antihypertensive effects, increases the release of ATP from vascular endothelial cells, leading to reduction of the blood pressure rise characteristic of aging (Hashimoto et al, 1998). It has been proposed that there is prognostic value of stress myocardial perfusion imaging using ATP at the beginning of hemodialysis treatment in patients with end-stage renal disease (Hase et al, 2004). P2X 4 receptors are localized in the syncytiotrophoblast, stroma, and fetal capillary endothelial cells of human placenta.…”

Ischemia and inflammation on chronic kidney disease

“…A number of reports indicated prognostic value of MPI suggested for patients with suspected or extant CAD and those with CKD. [8][9][10][11][12][13][14][15] The current report is a multicenter prospective cohort study in Japan to determine the ability of MPI to diagnose CAD and predict the outcomes of patients with CKD who are not definitively diagnosed with CAD (This study). The study aimed to clarify whether MPI can predict cardiac events and determine whether renal dysfunction combined with MPI abnormalities provides additional prognostic information to conventional markers.…”

“…This finding seems to be concordant to the previous findings indicating importance of myocardial ischemia for CKD patient outcome. [10][11][12][13][14][15] In other words, CKD patients with severe myocardial ischemia with reduced eGFR with or without elevated CRP are suitable candidates for coronary angiography and subsequent coronary intervention in order to improve their outcome.…”

“…This is somewhat different from many previous prognostic reports using gated perfusion SPECT. [8][9][10][11][12][13][14][15] In addition, the patient criteria include those with suspected ischemic CAD. It seems to be important to clarify how many of them have symptomatic and unstable conditions, indicating angina at rest or unstable angina.…”