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Kidney Week

Abstract: TH-PO137

Myocardial Perfusion Reserve Is Preserved in Patients with Kidney Transplant

Session Information

Category: Transplantation

  • 1801 Transplantation: Basic

Authors

  • Päivärinta, Johanna M., Turku University Central Hospital, Turku, Finland
  • Metsarinne, Kaj P., Turku University Central Hospital, Turku, Finland
  • Knuuti, Juhani, PET center, Turku, Finland
  • Löyttyniemi, Eliisa, University of Turku, Turku, Finland
  • Koivuviita, Niina S., Turku University Central Hospital, Turku, Finland
Background

Chronic kidney disease (CKD) has been associated with decreased myocardial perfusion reserve (MPR), the ratio of stress and rest perfusion. MPR reflects the capacity of vascular bed to increase perfusion and reflects the endothelial function and microvascular responsiveness. The effect of kidney transplantation on MPR is unknown. In this study our aim was to assess MPR of kidney transplant patients.

Methods

10 healthy subjects and 19 kidney transplant patients without manifest atherosclerotic disease and with mild to moderate kidney impairment were included in the study. The average age of kidney transplant patients was 37 +/-23 months. Myocardial perfusion (MP) was measured by means of [15O]H2O PET (positron emission tomography) at rest and during adenosine infusion.

Results

MP was statistically significantly higher at rest in the kidney transplant patients than in the healthy controls (p=0.0015). After correction by cardiac work load (basal MPcorr, corrected basal myocardial blood flow, [(MP/own RPP)xRPP average of the healthy]) the difference between the groups disappeared. Coronary vascular resistance (CVR) at rest and CVR and MP at stress were comparable between the groups. Although MPR was reduced, MPRcorr (=stress flow/basal MPcorr ) did not differ between the kidney transplant patients and the healthy controls.

Conclusion

MP and CVR during stress are preserved in the kidney transplant patients with mild to moderate CKD. The reduced MPR is explained by increased resting MP which is likely linked with increased cardiac workload due to sympathetic overactivation in the transplant patients.

 Kidney transplant patientsControls
 N=19N=10
Basal MP (ml/min/g)1.3 (0.4)*1.0 (0.2)
RPP10053 (2878)*6723 (1112)
Basal MP corr (ml/min/g)0.9 (0.2)1.0 (0.3)
Stress MP (ml/min/g)3.8 (1.0)4.0 (0.9)
MPR3.0 (0.9)*4.2 (1.0)
MPR corr4.3 (1.6)4.1 (1.1)
CVR basal [mmHgmL(-1)min(-1)g(-1)]83 (19)93 (21)
CVR stress [mmHgmL(-1)min(-1)g(-1)]27 (9)22 (8)

Values are mean (SD), *P<0.05 controls versus kidney transplant patients

Funding

  • Private Foundation Support