Document Detail


Combined dipyridamole-exercise stress echocardiography for detection of myocardial ischemia in hemodialysis patients: an alternative to stress nuclear imaging.
MedLine Citation:
PMID:  12324908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stress nuclear imaging is the noninvasive technique currently used to detect coronary artery disease (CAD) in dialysis patients. Stress echocardiography is recognized as an alternative to stress nuclear imaging for the general population. The aim of this study is to assess the diagnostic accuracy of stress echocardiography for detecting myocardial ischemia in hemodialysis patients. METHODS: Stress echocardiography and stress technetium-99m-tetrofosmin (Myoview; Amersham International Plc) imaging were performed simultaneously for 66 asymptomatic hemodialysis patients in a single session, using a combination of high-dose dipyridamole and symptom-limited exercise. Coronary angiography was performed in 44 patients with at least one abnormal noninvasive test result or who were considered high-risk despite normal noninvasive test results. RESULTS: Results for stress echocardiography were abnormal in 15 patients (22%); stress Myoview, in 14 patients (21%); and coronary angiography, in 12 patients (18%). The sensitivity of stress echocardiography for detecting myocardial ischemia (defined as stress Myoview defect) was 86%; specificity, 94%; positive predictive value, 80%; negative predictive value, 96%; and overall accuracy, 92%. The sensitivity of stress echocardiography for detecting CAD (defined as abnormal coronary angiography result) was 83%; specificity, 84%; positive predictive value, 67%; negative predictive value, 93%; and overall accuracy, 84%. Stress echocardiography and stress Myoview did not differ significantly in overall accuracy for detecting CAD (84% versus 91%; P = not significant). CONCLUSION: In hemodialysis patients, combined dipyridamole-exercise echocardiography is an accurate method to detect both myocardial ischemia and CAD and represents an alternative to stress nuclear imaging.
Authors:
Michel Dahan; Béatrice M Viron; Elisabeth Poiseau; Amir M Kolta; Nicolas Aubry; Catherine Paillole; Fabienne Pessione; François Bonnin; Damien Logeart; René Gourgon; Françoise E Mignon
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  40     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-26     Completed Date:  2002-10-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  737-44     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by the National Kidney Foundation, Inc.
Affiliation:
Nephrology Department, Bichat Hospital, Paris, France. ndahan@wanadoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Angiography
Coronary Artery Disease / diagnosis
Dipyridamole / diagnostic use*,  pharmacology
Echocardiography, Stress / drug effects,  methods*
Exercise Test / methods*
Female
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  radiography,  radionuclide imaging
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Radionuclide Ventriculography
Radiopharmaceuticals / diagnostic use
Renal Dialysis / methods*
Risk Assessment / methods
Sensitivity and Specificity
Vasodilator Agents / diagnostic use,  pharmacology
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/Vasodilator Agents; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 58-32-2/Dipyridamole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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