Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation
- St. Louis Univ. School of Medicine, MO (USA)
Patients with diabetes and end-stage renal failure are known to have a high risk for cardiac morbidity and mortality associated with renal transplantation. The most efficient method to determine preoperative cardiac risk has not been established. To determine the effectiveness of intravenous dipyridamole thallium imaging in predicting cardiac events, 40 diabetic renal transplant candidates were studied preoperatively in a prospective trial. The study group consisted of 40 patients whose average age was 42 years (range 27 to 64); 34 (85%) were hypertensive and 21 (53%) were cigarette smokers. Cardiac history included chest pain in 6 patients and prior myocardial infarction in 3 patients. Dipyridamole thallium imaging showed reversible defects in 9 patients, fixed defects in 8 patients and normal scans in 23 patients. Dipyridamole thallium imaging was performed using 0.56 mg/kg of dipyridamole infused intravenously over 4 minutes. Cardiac events occurred only in patients with reversible thallium defects, of which there were 6. Of these 6 patients, 3 had cardiac events before transplantation and 3 had them in the early postoperative phase (within 6 weeks of surgery). Of 21 patients who underwent renal transplantation, 3 had cardiac events within 6 weeks of transplantation. The average duration of follow-up was 11 months (range 1 to 21). Thus, dipyridamole thallium imaging is an effective method of identifying renal transplant candidates likely to develop cardiac complications. Routine coronary angiography may not be necessary to screen all renal transplant candidates for coronary artery disease before surgery.
- OSTI ID:
- 6707251
- Journal Information:
- American Journal of Cardiology; (USA), Vol. 65:22; ISSN 0002-9149
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
CARDIOVASCULAR DISEASES
DIAGNOSIS
KIDNEYS
TRANSPLANTS
DIABETES MELLITUS
IMAGE PROCESSING
MAN
PATIENTS
RADIOISOTOPE SCANNING
THALLIUM ISOTOPES
UROGENITAL SYSTEM DISEASES
VASODILATORS
ANIMALS
BODY
CARDIOVASCULAR AGENTS
COUNTING TECHNIQUES
DISEASES
DRUGS
ENDOCRINE DISEASES
ISOTOPES
MAMMALS
METABOLIC DISEASES
ORGANS
PRIMATES
PROCESSING
VERTEBRATES
550601* - Medicine- Unsealed Radionuclides in Diagnostics