Prognostic Significance of Noninvasive Simultaneous Renal and Cardiac Perfusion: Interrogating Mechanisms of Cardiovascular-Kidney Interactions
Main finding · Composite cardiovascular outcome (all-cause mortality, heart failure hospitalization, or acute coronary syndrome)Result — go to the resultAdjusted hazard ratio 5.21 95% CI 1.53–17.75Authors' conclusion
Impaired renal blood flow is associated with cardiac and kidney events, independent of the highly prognostic estimated glomerular filtration rate and myocardial flow reserve. Simultaneous quantification of cardiac and renal perfusion by noninvasive 13 N-ammonia positron emission tomography-computed tomography may provide a valuable tool to interrogate pathophysiology and prognosis in the cardiovascular-kidney-metabolic syndrome.
Study context
- Population
- Consecutive patients who underwent 13 N-ammonia positron emission tomography-computed tomography myocardial perfusion imaging between September 1, 2019, and March 1, 2020
- Participants
- 295 consecutive patients
- Exposure
- Lower vs higher renal blood flow
- Outcome
- Composite cardiovascular outcome:
- All-cause mortality
- Heart failure hospitalization
- Acute coronary syndrome
- Follow-up
- 4.0 (interquartile range, 1.7-4.1) years
Methodological detailsconsecutive patients, single-centre (Brigham and Women’s Hospital, Boston)
- Consecutive patients
- Single-centre (Brigham and Women’s Hospital, Boston)
Main finding
As reported in the abstract
Adjusted hazard ratio
5.21
95% CI 1.53–17.75
P = 0.008
Observational data: associations, not effects.
Further findings
Composite renal outcome (25% reduction in estimated glomerular filtration rate or end-stage renal disease)
- Lower renal blood flow associated with an elevated risk of adverse renal outcomes
- P = 0.026
- Independent of estimated glomerular filtration rate and myocardial flow reserve
Baseline characteristics
- Mean age
- 65.6 years
- Body mass index
- 29.2 kg/m 2
- Female
- 49%
- Chronic kidney disease stage ≥3
- 36%
Original publication
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