The detection of myocardial ischemia in end-stage renal disease.
The outcome of acute coronary syndromes is usually poor in patients with end-stage renal disease (ESRD), and the early detection of myocardial ischemia is therefore essential in this group. However, the diagnosis of ischemina is often problematic in patients with ESRD, as cardiac symptoms and electrocardiography are not reliable predictors in this context. Silent ischemia is common and resting ECG is often abnormal in patients with ESRD. Therefore, alternatives to these predictors have been sought, and this review explores the role of myocardial perfusion imaging, dobutamine stress echocardiography and biochemical markers for use in the diagnosis of ischemia and risk stratification in patients with ESRD.
Sharma
Rajan
R
Ealing Hospital NHS Trust, Uxbridge Road. Southal, Middlesex UB1 3HW UK. rajdoc.sharma@tiscali.co.uk
Pellerin
Denis
D
Brecker
Stephen J D
SJ
D015415:Biomarkers / Q000097:blood; D025401:Echocardiography, Stress / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D011877:Radionuclide Imaging / Q000379:methods
D015415:Biomarkers