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

Citation

Bart, BA and Cen, Y-Y and Hendel, RC and Lee, R and Marwick, TH and Missov, ED and Bachour, FA and Herzog, CA, Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease, Journal of Nuclear Cardiology, 16, (4) pp. 507-515. ISSN 1071-3581 (2009) [Refereed Article]


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Copyright Statement

Copyright 2009 American Society of Nuclear Cardiology

DOI: doi:10.1007/s12350-009-9076-y

Abstract

    Objectives. We sought to assess and compare the diagnostic accuracy and prognostic value of dobutamine stress echocardiography (DSE), dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging (MPI) in patients with end-stage renal disease (ESRD).
    Background. The optimal stress imaging modality for patients with ESRD has not yet been determined.
    Methods. Forty-nine patients with ESRD underwent DSE, dobutamine SPECT MPI, and adenosine SPECT MPI. The primary endpoint of the trial was concordance between stress tests with respect to the presence or absence of ischemia.
    Results. Agreement on the presence or absence of ischemia between adenosine SPECT MPI and DSE was 69% (kappa = .25, P = NS). Agreement on the presence or absence of ischemia between adenosine and dobutamine SPECT MPI was 77% (kappa = .37, P = <.009). Summed stress scores for adenosine and dobutamine SPECT MPI studies were highly correlated (r = .9, P = <.0001). DSE and SPECT MPI results provided incremental prognostic information when added to clinical variables.
    Conclusions. There is moderate concordance between DSE and adenosine SPECT MPI in ESRD patients referred for stress testing. Interobserver agreement was higher for SPECT MPI compared to DSE. Based on these observations, the optimal approach for diagnosing severe coronary artery disease and assessing risk in patients with ESRD has yet to be determined, but appears to warrant further investigation.

Item Details

Item Type:Refereed Article
Keywords:echocardiography, dobutamine, myocardial perfusion imaging, SPECT, pharmacologic stress, adenosine
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
ID Code:90779
Year Published:2009
Web of Science® Times Cited:11
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-04-23
Last Modified:2014-05-20
Downloads:0

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