Predictive value of stress myocardial perfusion imaging with gated SPECT for cardiac death in patients with chronic kidney disease
10.3760/cma.j.cn321828-20240708-00250
- VernacularTitle:SPECT负荷心肌灌注显像对慢性肾脏病患者心源性死亡的预测价值
- Author:
Ying ZHANG
1
;
Jian JIAO
1
;
Zhi CHANG
1
;
Xu HAN
1
;
Quan LI
1
;
Junqi LI
1
;
Yehong ZHANG
1
;
Xiaofen XIE
1
;
Wei DONG
1
;
Hongzhi MI
1
Author Information
1. 首都医科大学附属北京安贞医院核医学科，北京 100029
- Publication Type:Journal Article
- Keywords:
Renal insufficiency, chronic;
Heart arrest;
Myocardial perfusion imaging;
Technetium Tc 99m sestamibi;
Tomography, emission-computed, single-photon;
Foreca
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(6):346-351
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical predictive value of SPECT myocardial perfusion imaging (MPI) in the occurrence of cardiac death in patients with chronic kidney disease (CKD).Methods:A retrospective follow-up was performed for 160 patients (109 males, 51 females; age: 68.5(61.0, 74.0) years) who underwent MPI in Beijing Anzhen Hospital, Capital Medical University between June 2017 and March 2024. The 17-segment 5-point method was used for image analysis to obtain the left ventricular myocardial perfusion and functional parameters. The patients were followed up for cardiac death, and divided into death group and survival group. Clinical data of those 2 groups were compare by χ2 test, the independent-sample t test or Mann-Whitney U test. Cox proportional hazards regression analysis was used to analyze the predictors related to cardiac death. The ROC curve was used to analyze the performance of predictors. Survival curves were obtained by the Kaplan-Meier method, and log-rank test was performed to compare the difference between 2 groups. Results:The follow-up time of 160 patients with CKD was 26.0(10.0, 46.5) months. Of 160 patients, 17 died and 143 survived. There were statistically significant differences in body mass index (BMI), previous myocardial infarction, previous revascularization, hypersensitive C-reactive protein (hs-CRP), positive MPI, left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) between the death group and the survival group ( χ2 values: 4.58-16.13, t values: -2.34, -3.97, Z values: from -2.81 to 5.02, all P<0.05). Multivariate Cox regression analysis showed that SSS (hazard ratio ( HR)=1.153, 95% CI: 1.062-1.252, P=0.001) and hs-CRP ( HR=1.031, 95% CI: 1.004-1.058, P=0.023) were independent risk factors for cardiac death in patients with CKD. The optimal cut-off value of SSS for predicting cardiac death in those patients was determined to be 8 with the AUC of 0.815, and the incidence of cardiac death in the SSS ≥8 group was significantly higher than that in the SSS<8 group (33.3%(12/36) vs 4.0%(5/124); χ2 = 25.44, P<0.001). Conclusion:MPI is an important imaging method for the evaluation of cardiac death in patients with CKD, SSS and hs-CRP are important risk factors in predicting cardiac death in those patients.
