1. ¹Cardiovascular Division, Toujinkai Hospital, Kyoto, Japan
2. ²Division of Nephrology, Toujinkai Hospital, Kyoto, Japan
3. ³Division of Urology, Toujinkai Hospital, Kyoto, Japan
4. ⁴Division of Orthopedics, Toujinkai Hospital, Kyoto, Japan
5. ⁵Division of Surgery, Toujinkai Hospital, Kyoto, Japan
6. ⁶Department of Clinical Sciences and Laboratory Medicine, Kansai Medical University, Osaka, Japan

Correspondence: Masato Nishimura, Cardiovascular Division, Toujinkai Hospital, 83-1, Iga, Momoyama-cho, Fushimi-ku, Kyoto 612-8026, Japan. E-mail: mnishimura@tea.ocn.ne.jp

Received 14 December 2007; Revised 14 February 2008; Accepted 26 March 2008; Published online 4 June 2008.

Abstract

We prospectively evaluated if impaired myocardial fatty acid metabolism is involved in cardiac death after revascularization by percutaneous coronary artery intervention in dialysis patients. A cohort of hemodialysis patients was assessed by dual single-photon emission computed tomography using the radioiodinated fatty acid analogue BMIPP and radiolabeled thallium chloride. Tomography was done within one month before the first coronary intervention and at the last follow-up angiography at which neither restenosis nor de novo lesions were detected. Radiolabel uptake on tomography images was graded in segments and calculated as summed BMIPP or thallium scores. Among the 90 hemodialysis patients in the study, 19 died of cardiac events. Multivariate Cox hazard analysis found a significant association of cardiac death with the BMIPP summed scores at the last follow-up angiography. Kaplan–Meier analysis showed the cardiac death-free survival rates at 3 years of follow-up were significantly higher in patients with lower BMIPP summed scores. These results suggest that myocardial fatty acid imaging may be a useful test to identify high risk groups of cardiac death in hemodialysis patients.