Assessment of coronary artery disease in hemodialysis patients with delayed systolic blood pressure response after exercise testing.
BACKGROUND
We evaluated usefulness of the postexercise systolic blood pressure (SBP) response for detecting coronary artery disease (CAD) in hemodialysis patients.


METHODS
A treadmill exercise testing was done, and the SBP response was measured in 44 hemodialysis patients (30 men, 14 women; age 41 to 81 years). The postexercise SBP response was defined as the ratio of SBP after 3 minutes of recovery to SBP at peak exercise.


RESULTS
The SBP ratio of the 25 subjects with coronary artery stenosis (1.01+/- 0.13) was significantly greater (p<0.01) than 19 subjects without coronary artery stenosis (0.83+/- 0.10). An SBP ratio greater than 0.92 identified CAD with higher sensitivity, specificity, and accuracy than did the conventional ST-segment depression criterion (76 vs. 56%, 90 vs. 53%, and 82 vs. 55%, respectively).


CONCLUSIONS
Determination of the SBP ratio is a clinically useful, noninvasive method for accurately detecting CAD in hemodialysis patients.
Fukui
Masayoshi
M
Department of Medicine II, Kansai Medical University, Osaka, Japan. fukuim@takii.kmu.ac.jp
Mori
Yasukiyo
Y
Takehana
Kazuya
K
Masaki
Hiroya
H
Motohiro
Masayuki
M
Sakamoto
Norihiko
N
Kitamura
Tetsuya
T
Yoshida
Susumu
S
Nakamura
Seishi
S
Baden
Masato
M
Nishikawa
Mitsushige
M
Iwasaka
Toshiji
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis