Effects of chronic kidney disease on myocardial washout rate of thallium-201 in patients with normal myocardial perfusion on single photon emission computed tomography.

Background: Myocardial perfusion single photon emission computed tomography (SPECT) is often performed even in patients with chronic kidney disease (CKD). We assessed the effects of CKD on myocardial washout rate (WR) of thallium (Tl)-201 in patients with normal myocardial perfusion on SPECT.

Methods: Two hundred and fifty-six patients with normal myocardial perfusion were enrolled in this study. CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m. Patients with eGFR ≥ 60 ml/min/1.73 m were assigned to a control group. The mean myocardial WR of Tl-201 was calculated from the stress and the redistribution Bull's eye maps.

Results: With progressive CKD stages, systolic blood pressure and incindence of hypertension were increased. All patients in CKD stage 5 group were being treated with hemodialysis. Myocardial WR of Tl-201 was significantly higher in all of the CKD groups than control group. With progressive CKD stages, myocardial WR of Tl-201 was increased (stage 3, 52.2 ± 9.2%; stage 4, 55.5 ± 8.1%; and stage 5, 58.9 ± 5.6%). Multivariate analysis showed that hemoglobin (β = -0.24, p < 0.001) and eGFR (β = -0.24, p = 0.002) were the major determinants of myocardial WR of Tl-201, but hemodialysis was not.

Conclusions: Our data suggest that CKD is associated with increased myocardial WR of Tl-201 in patients with normal perfusion on SPECT.