Kidney Week

Abstract: SA-PO1169

Prognostic Value of Left Ventricular Ejection Fraction Discrepancies Between Thallium Myocardial Perfusion Scan and Echocardiography in Patients with CKD

Session Information

• CKD: SGLT2 Inhibitors and GLP-1 RAs for Kidney Health
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Teng, Jen Hao, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Jen Hao Teng, MD

• Liu, Yi-Hsueh, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Hsueh Liu

• Lin, Yi-Ting, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Ting Lin, MD, PhD

• Lin, Ming-Yen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ming-Yen Lin, PhD

• Huang, TengHui, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

TengHui Huang, MS

• Kuo, Mei-Chuan, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Mei-Chuan Kuo, MD

• Chiu, Yi-Wen, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Yi-Wen Chiu, MD

• Hwang, Shang-Jyh, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Shang-Jyh Hwang, MD

• Wu, Ping-Hsun, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Kaohsiung City, Taiwan

Ping-Hsun Wu, MD, MS, PhD

Background

Patients with chronic kidney disease (CKD) are prone to develope heart failure, and left ventricular ejection fraction (LVEF) is key for guiding treatment.This study investigates the discrepancies in LVEF measurements between echocardiography and thallium scans in CKD patients, and their association with survival and cardiovascular outcomes.

Methods

The retrospective study included adult CKD patients who underwent both echocardiography and thallium perfusion scans within 90 days at Kaohsiung Medical University Hospital care system. Patients were classified according to their LVEF ratio (thallium scan LVEF/echocardiography LVEF): reference (ratio 0.9–1.1), low-ratio (<0.9), and high-ratio (>1.1). Primary outcomes, including overall survival, acute coronary syndrome, and heart failure hospitalization, were evaluated using Kaplan-Meier survival analysis and multivariable Cox regression models adjusted for age, sex, comorbidities, and biochemical parameters.

Results

1,173 patients were categorized based on their LVEF ratio: reference (n = 367), low-ratio (n = 591), and high-ratio (n = 215). A moderate positive correlation (r = 0.663) was found between LVEF measurements from thallium scan and echocardiography. The low-ratio group exhibited significantly worse overall survival (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.10–1.81], p = 0.006), higher incidence of acute coronary syndrome (HR 1.47, 95% CI 1.05–2.06, p = 0.026), and increased heart failure hospitalizations (HR 1.46, 95% CI 1.14–1.86, p = 0.002) compared to the reference groups. Kaplan-Meier survival curves consistently indicated the lowest survival probability in the low-ratio group.

Conclusion

The thallium scan/echocardiography LVEF ratio appears to be a meaningful stratification tool for cardiovascular risk assessment, with a ratio <0.9 associated with higher mortailty and poorer cardiovascular outcomes.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025z2k2abz9