Myocardial microvascular dysfunction in chronic kidney disease and hemodialysis patients evaluated by pharmacological stress 13N-ammonia positron emission tomography myocardial perfusion imaging

Objectives We investigated myocardial blood flow (MBF) and coronary flow reserve (CFR) evaluated by 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) in chronic kidney disease (CKD) and hemodialysis patient.

Methods MBF was evaluated at rest and ATP induced hyperemia, and CFR was calculated by 13N-ammonia PET MPI. Twenty hemodialysis (HD) patients, 10 CKD (eGFR < 60 mL/min/m2) patients without HD, and 17 non-CKD patients without perfusion defect (SSS < 3) were investigated.

Results Rest MBF was significantly increased in HD patients than CKD or non-CKD patients. No significant differences between each study group in stress MBF. CFR were significantly impaired in CKD and HD patient than non-CKD patient. No significant correlations between each parameter and hemoglobin or blood pressure were observed.

Conclusions Impaired CFR and increased rest MBF were observed in hemodialysis and CKD patient evaluated by pharmacological stress 13N-ammonia PET MPI.