Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease

Bart, Bradley A.; Cen, Ye-Ying; Hendel, Robert C.; Lee, Ramond; Marwick, Thomas H.; Missov, Emil; Bachour, Fouad; Herzog, Charles A.

doi:10.1007/s12350-009-9076-y

Cited by 15 publications

(8 citation statements)

References 52 publications

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“…Routine angiography, even by computed tomography scanning, has risks and, even in the best centers, the intervention rate is low. 5,6 One underlying reason is that coronary artery disease is only a part of the cardiovascular disease profile of patients with ESRD, in which uremic cardiomyopathy (the principal form of which is ventricular hypertrophy, with myocardial fibrosis) is an important determinant of sudden cardiac death and heart failure. 1,2,7 On the other hand, it is clear from screening programs that exercise capacity in potential transplant recipients is a strong predictor of post-transplant outcomes.…”

mentioning

confidence: 99%

Functional Cardiopulmonary Exercise Testing in Potential Renal Transplant Recipients

Fellström

Holdaas

Jardine

2014

Journal of the American Society of Nephrology

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mentioning

confidence: 99%

Functional Cardiopulmonary Exercise Testing in Potential Renal Transplant Recipients

Fellström

Holdaas

Jardine

2014

Journal of the American Society of Nephrology

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“…The presence of coronary flow on post‐stress images and its absence on rest images represent an area of ischemia. The test sensitivity is often greater for MPI, while specificity is slightly higher for DSE .…”

Section: Discussionmentioning

confidence: 99%

Myocardial perfusion imaging is an effective screening test for coronary artery disease in liver transplant candidates

Baker

Chambers

McQuillan

et al. 2015

Clinical Transplantation

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A reliable screening test for coronary artery disease (CAD) in liver transplant (LT) candidates with end-stage liver disease is essential because a high percentage of perioperative mortality and morbidity is CAD-related. In this study, the effectiveness of myocardial perfusion imaging (MPI) for identification of significant CAD in LT candidates was evaluated. Records of 244 patients meeting criteria for MPI were evaluated: 74 met inclusion criteria; 40 had a positive MPI and cardiology follow-up; 27 had a negative MPI and underwent LT; and seven had a negative MPI and then had coronary angiography or a significant cardiac event. A selective MPI interpretation strategy was established where MPI-positive patients were divided into high, intermediate, and low CAD risk groups. The overall incidence of CAD in this study population was 5.1% and our strategy resulted in PPV 20%, NPV 94%, sensitivity 80%, and specificity 50% for categorizing CAD risk. When applied only to the subset of patients categorized as high CAD risk, the strategy was more effective, with PPV 67%, NPV 97%, sensitivity 80%, and specificity 94%. We determined that renal dysfunction was an independent predictive factor for CAD (p < 0.0001, odds ratio = 8.1), and grades of coronary occlusion correlated significantly with chronic renal dysfunction (p = 0.0079).

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“…When evaluating two identical physiological tests (nuclear SPECT) for the detection of ischemia performed using the same vasodilator (adenosine) in two different settings, the agreement is moderate at 62 % with a κ value of 0.46[ 16 ]. Simultaneous evaluation for two different imaging modalities (echocardiography and nuclear SPECT) during the same dobutamine stress evaluation have demonstrated an agreement of 69 % with a κ value of 0.25[ 17 ]. Thus, the agreement between CTA and CMR in the current study is excellent compared with the concordance of conventional tests.…”

Section: Discussionmentioning

confidence: 99%

Concordance and diagnostic accuracy of vasodilator stress cardiac MRI and 320-detector row coronary CTA

Chen

Bandettini

Shanbhag

et al. 2013

Int J Cardiovasc Imaging

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Vasodilator stress cardiac magnetic resonance (CMR) detects ischemia whereas coronary CT angiography (CTA) detects atherosclerosis. The purpose of this study was to determine concordance and accuracy of vasodilator stress CMR and coronary CTA in the same subjects. We studied 151 consecutive subjects referred to detect or exclude suspected obstructive coronary artery disease (CAD) in patients without known disease or recurrent stenosis or ischemia in patients with previously treated CAD. Vasodilator stress CMR was performed on a 1.5 T scanner. CTA was performed on a 320-detector row system. Subjects were followed for cardiovascular events and downstream diagnostic testing. Subjects averaged 56 ± 12 years (60 % male), and 62 % had intermediate pre-test probability for obstructive CAD. Follow-up averaged 450 ± 115 days and was 100 % complete. CMR and CTA agreed in 92 % of cases (κ 0.81, p < 0.001). The event-free survival was 97 % for non-ischemic and 39 % for ischemic CMR (p < 0.0001). The event-free survival was 99 % for non-obstructive and 36 % for obstructive CTA (p < 0.0001). Using a reference standard including quantitative invasive angiography or major cardiovascular events, CMR and CTA had respective sensitivities of 93 and 98 %; specificities of 96 and 96 %; positive predictive values of 91 and 91 %; negative predictive values of 97 and 99 %; and accuracies of 95 and 97 %. Non-ischemic vasodilator stress CMR or non-obstructive coronary CTA were highly concordant and each confer an excellent prognosis. CMR and CTA are both accurate for assessment of obstructive CAD in a predominantly intermediate risk population.

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Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease

Cited by 15 publications

References 52 publications

Functional Cardiopulmonary Exercise Testing in Potential Renal Transplant Recipients

Functional Cardiopulmonary Exercise Testing in Potential Renal Transplant Recipients

Myocardial perfusion imaging is an effective screening test for coronary artery disease in liver transplant candidates

Concordance and diagnostic accuracy of vasodilator stress cardiac MRI and 320-detector row coronary CTA

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