Feasibility, safety and accuracy of dobutamine/atropine stress echocardiography for the detection of coronary artery disease in renal transplant candidates.
OBJECTIVE
To evaluate the feasibility, safety and accuracy of dobutamine/atropine stress echocardiography (DASE) for the detection of coronary artery disease (CAD) in renal transplant candidates.


METHODS
Patients candidates to renal transplant were submitted consecutively to DASE and coronary angiography. The adopted angiographic criteria for CAD were an obstructive lesion of > or = 50% and > or = 70%.


RESULTS
148 patients underwent the DASE and the coronary angiography. Mean age was 52 +/- 9 years, 69% of the patients were males; 27% had diabetic nephropathy and 73% had LVH; 63% were asymptomatic; 36% and 22% presented coronary obstructions > or = 50% and 70%, respectively. The DASE performance was 91% and major complication rate was 2.7%. The sensibility, specificity and accuracy for the diagnosis of coronary obstruction > 50% were 53% (CI:45-61), 87% (CI:81-93), and 75% (CI:63-83) respectively. For coronary obstruction > or = 70% these values were, respectively, 71% (CI:64-92), 85% (CI:79-91) and 81% (CI:75-87). The sensibility to detect univessel and multivessel disease was 41% (CI:19-63) and 78% (CI:64-92), respectively.


CONCLUSIONS
The DASE was practical and safe; however, it presented a poor result for the detection of CAD regarding obstructions > or = 50%. It can be a useful screening for the detection of CAD in candidates with obstructions > or = 70% and multivessel disease.
Ferreira
Pedro Antonio Muniz
PA
Universidade Federal de São Paulo, Escola Paulista de Medicina, Hospital do Rim e Hipertensão e Hospital São Paulo, São Paulo, SP, Brazil. pamuniz@cardiol.br
de Lima
Valter Correia
VC
Campos Filho
Orlando
O
Gil
Manuel Adan
MA
Cordovil
Adriana
A
Machado
Cristiano Vieira
CV
Pestana
José Osmar Medina
JO
Carvalho
Antonio Carlos de Camargo
AC
D000328:Adult; D000368:Aged; D001285:Atropine; D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D025401:Echocardiography, Stress; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D002316:Cardiotonic Agents; D004280:Dobutamine; D001285:Atropine