Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

1532-65512762020DecJournal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyJ Nucl CardiolQuantitative blood flow evaluation of vasodilation-stress compared with dobutamine-stress in patients with end-stage liver disease using ⁸²Rb PET/CT.204820592048-205910.1007/s12350-018-01516-8Our aim was to determine if end-stage liver disease (ESLD) is associated with an attenuated response to vasodilator-stress or dobutamine-stress using ⁸²Rb-PET MPI with blood flow quantification.Pre-liver transplant patients who had a normal dipyridamole-stress (n = 27) or dobutamine-stress (n = 26) ⁸²Rb PET/CT MPI study with no identifiable coronary artery calcium were identified retrospectively and compared to a prospectively identified low-risk of liver disease dipyridamole-stress control group (n = 20). The dipyridamole-stress liver disease group had a lower myocardial flow reserve (MFR) (1.89 ± 0.79) than the control group (2.79 ± 0.96, P < .05). The dobutamine-stress group had a higher MFR than both other groups (3.69 ± 1.49, P < .05). A moderate negative correlation between MELD score and MFR was demonstrated for the dipyridamole-stress liver disease group (r = - 0.473, P < .05). This correlation was not observed for the dobutamine-stress liver disease group (r = - 0.253, P = .21). The liver failure group as a whole (n = 53) had a higher resting myocardial blood flow (0.97 ± 0.33 mL/min/g) than the control group (0.82 ± 0.26, P < .05).Dipyridamole demonstrates an attenuated vasodilatory response in ESLD patients compared to a non-ESLD control group related to higher resting blood flow and comparatively reduced stress blood flow. Dobutamine does not demonstrate this effect implying it may be the preferred pharmacologic MPI stress agent for ESLD patients.AbeleJonathan TJTDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada. jabele@ualberta.ca.Department of Radiology and Diagnostic Imaging, 2A2.42 Walter C MacKenzie Health Sciences Centre, University of Alberta, 8440 - 112 Street NW, Edmonton, Alberta, T6G 2B7, Canada. jabele@ualberta.ca.RaubenheimerMoniqueMFaculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.BainVincent GVGLiver Unit, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.WandzilakGregGDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.AlHulaimiNajiNDivision of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.CouldenRichardRDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.deKempRobert ARADivision of Cardiology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.KleinRanRDivision of Nuclear Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.WilliamsRandall GRGDivision of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.WarshawskiRobert SRSDepartment of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.LalondeLucille DLDDivision of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.engMIS-100935CIHRCanadaComparative StudyJournal ArticleResearch Support, Non-U.S. Gov't20181119