Type of dialysis may influence the prognostic value of myocardial perfusion imaging in end stage renal disease: an observational [¹³N]NH₃ PET/CT study.
7 affiliations
- 1Department of Nuclear Medicine, University Hospital Münster, Münster, Germany. [email protected].
- 2Department of Nuclear Medicine, Bonifatius Hospital Lingen, Wilhelmstrasse 13, 49808, Lingen (Ems), Germany. [email protected].
- 3Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.
- 4Department of Internal Medicine, Marienhospital Osnabrück, Osnabrück, Germany.
- 5Department of Nuclear Medicine, German Medical Center, Limassol, Cyprus.
- 6European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.
- 7Department of Internal Medicine D, General Internal Medicine and Nephrology, University Hospital Münster, Münster, Germany.
Abstract
Background
Patients with end-stage renal disease (ESRD) exhibit an elevated risk of cardiovascular events, with imaging-based risk stratification becoming increasingly important. This study compares the prognostic utility of [¹³N]NH₃ PET/CT assessing myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary artery calcium score (CACS) as well as 3D carotid ultrasound (for carotid plaque burden; cPB) in hemodialysis (HD) versus peritoneal dialysis (PD) patients listed for kidney transplantation.Results
41 ESRD patients (HD n = 31; PD n = 10; median follow-up 4.9 years) without known coronary artery disease underwent myocardial perfusion imaging with [¹³N]NH₃ PET/CT, CACS, and 3D carotid ultrasound. HD patients exhibited lower myocardial stress blood flow (MBFstress) and CFR compared to PD patients (2.67 ± 0.67 vs. 2.97 ± 0.69; p = 0.24 and 2.5 ± 0.74 vs. 3.08 ± 1.12; p = 0.07). In the HD subgroup, only MBFstress correlated inversely with CACS and cPB (r = -0.32; p < 0.05 and r = -0.44; p < 0.05), whereas CFR did not (r=-0.14; p = 0.47 and r= -0.14; p = 0.44). On the other hand, both MBFstress and CFR were predictive of cardiovascular events in HD patients, although the number of events was low (n = 4). In contrast, PD patients exhibited only one single cardiovascular event in the follow-up and no significant imaging correlations were observed.Conclusions
MBFstress and CFR may emerge as prognostic markers for cardiovascular events in HD patients whereas their prognostic power in PD patients remains uncertain. HD patients show more pronounced impairment in MBFstress and atherosclerotic plaque burden in the carotid artery, highlighting particularly this parameter as a prognostic marker in this group.
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BibTeX
@article{wenning2026type,
title = {{Type of dialysis may influence the prognostic value of myocardial perfusion imaging in end stage renal disease: an observational [¹³N]NH₃ PET/CT study.}},
author = {Christian Wenning and Thekla Maria Gosmann and Alexis Vrachimis and Michael A Schäfers and Stefan Reuter},
journal = {EJNMMI research},
year = {2026},
month = oct,
doi = {10.1186/s13550-026-01522-9},
url = {https://europepmc.org/article/MED/42925457},
note = {CC BY},
}
RIS
TY - JOUR
TI - Type of dialysis may influence the prognostic value of myocardial perfusion imaging in end stage renal disease: an observational [¹³N]NH₃ PET/CT study.
AU - Christian Wenning
AU - Thekla Maria Gosmann
AU - Alexis Vrachimis
AU - Michael A Schäfers
AU - Stefan Reuter
PY - 2026
DA - 2026/10/24
JO - EJNMMI research
DO - 10.1186/s13550-026-01522-9
UR - https://europepmc.org/article/MED/42925457
AB - Background Patients with end-stage renal disease (ESRD) exhibit an elevated risk of cardiovascular events, with imaging-based risk stratification becoming increasingly important. This study compares the prognostic utility of [¹³N]NH₃ PET/CT assessing myocardial blood flow (MBF), coronary flow reserve (CFR) and coronary artery calcium score (CACS) as well as 3D carotid ultrasound (for carotid plaque burden; cPB) in hemodialysis (HD) versus peritoneal dialysis (PD) patients listed for kidney transplantation.Results 41 ESRD patients (HD n = 31; PD n = 10; median follow-up 4.9 years) without known coronary artery disease underwent myocardial perfusion imaging with [¹³N]NH₃ PET/CT, CACS, and 3D carotid ultrasound. HD patients exhibited lower myocardial stress blood flow (MBFstress) and CFR compared to PD patients (2.67 ± 0.67 vs. 2.97 ± 0.69; p = 0.24 and 2.5 ± 0.74 vs. 3.08 ± 1.12; p = 0.07). In the HD subgroup, only MBFstress correlated inversely with CACS and cPB (r = -0.32; p < 0.05 and r = -0.44; p < 0.05), whereas CFR did not (r=-0.14; p = 0.47 and r= -0.14; p = 0.44). On the other hand, both MBFstress and CFR were predictive of cardiovascular events in HD patients, although the number of events was low (n = 4). In contrast, PD patients exhibited only one single cardiovascular event in the follow-up and no significant imaging correlations were observed.Conclusions MBFstress and CFR may emerge as prognostic markers for cardiovascular events in HD patients whereas their prognostic power in PD patients remains uncertain. HD patients show more pronounced impairment in MBFstress and atherosclerotic plaque burden in the carotid artery, highlighting particularly this parameter as a prognostic marker in this group.
SN - 2191-219X
ER -