Abstract: SA-PO374
The Effect of Coronary Artery Status on Myocardial Perfusion Response to Hemodialysis
Session Information
- Hemodialysis and Frequent Dialysis: CV and Risk Prediction
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Hur, Lisa, Western University, London, Ontario, Canada
- Islam, Ali, Saint Joseph's Health Care London, London, Ontario, Canada
- Penny, Jarrin D., London Health Sciences Centre London Kidney Clinical Research Unit, London, Ontario, Canada
- Dorie, Justin R., London Health Sciences Centre London Kidney Clinical Research Unit, London, Ontario, Canada
- McIntyre, Christopher W., London Health Sciences Centre London Kidney Clinical Research Unit, London, Ontario, Canada
Background
Hemodialysis (HD) is associated with repetitive ischemia-reperfusion cardiac injury occurring during each treatment that accumulates with subsequent treatments. Conventional cardiovascular therapies effective in patients with atherosclerotic disease or myocardial infarction have been largely ineffective in treating HD-induced injuries. The objective of the present study was to use coronary CT angiography (CCTA) and intradialytic CT perfusion imaging to noninvasively evaluate the myocardial perfusion response during HD in patients with and without significant coronary artery stenosis.
Methods
CCTA images were acquired prior to HD (baseline) on ten patients and assessed by an experienced radiologist for clinically significant stenoses. In addition, dynamic contrast-enhanced CT scans (Revolution CT, GE) were conducted at baseline, peak HD stress, and 30 mins post HD. The dynamic CT images were analyzed using the Johnson-Wilson-Lee tracer kinetic model to quantify global myocardial perfusion (MP) of the left ventricle.
Results
Three patients were identified with clinically significant stenoses. In all patients, MP decreased from baseline to peak HD. However, MP response to HD was not significantly different between patients with clinically significant stenoses and those with no stenosis (Fig 1).
Conclusion
Preliminary results indicate that the coronary artery status does not affect the myocardial perfusion response to HD. This suggests that the decrease in MP during HD is caused by the treatment itself, rather than by coronary artery stenosis.