title: [Prognostic value of dobutamine stress echocardiography in patients with terminal renal insufficiency undergoing hemodialysis--a 5-year follow up].
abstract: BACKGROUND
  Patients with end-stage renal failure have high morbidity and mortality rates due to cardiovascular complications. Screening for coronary heart disease in these patients is of utmost importance. The aim of this study was to investigate the prognostic value of the dobutamine test in patients on hemodyalisis during a 5-year follow-up period.
  
  
  METHODS
  During the pretransplantation period, 24 patients on chronic hemodialysis underwent echocardiography and dobutamine echocardiography. The average age of patients was 51.50 +/- 7.35 years. The mean duration of dialysis was 74 +/- 40 months.
  
  
  RESULTS
  The dobutamine stress test was positive in 50% of patients, and undefined in 12.5%. The wall motion score index before the test was 1, and after the test it was 1.54 +/- 0.27. There were no serious complications. Left ventricular mass, diastolic and systolic dimension and posterior wall were significantly higher in patients with positive dobutamine stress results and they were associated with late cardiac morbidity and mortality. Five-year survival in patients with positive dobutamine stress results was 33.3% and 52.3% in patients with negative dobutamine results. Causes of mortality were as follows: cardiac 45.4%, cerebrovascular 18.1%, other causes 36.4%. Cardiogical complications were not the cause of death in any of the patients with negative dobutamine results. In dobutamine positive group 62.5% died from cardiological complications. During the 5-year period, cardiac death and manifest coronary disease occurred in 75% of patients with positive dobutamine stress results and only in one patient with negative dobutamine results. Sensitivity was 75%, specificity 89% and positive predictive value 90%.
  
  
  CONCLUSIONS
  Dobutamine stress echocardiography has a good predictive value for future cardiac events in hemnodyalisis patients, and in screening for coronary disease.
authors.affiliation: Klinicko-bolnicki centar Bezanijska kosa, Beograd. krotin@eunet.yu
authors.forename: Mirjana
authors.initials: M
authors.lastname: Krotin
authors.forename: Dejana
authors.initials: D
authors.lastname: Vuković
authors.forename: Olivera
authors.initials: O
authors.lastname: Stojanović
authors.forename: Branislav
authors.initials: B
authors.lastname: Milovanović
authors.forename: Dusica
authors.initials: D
authors.lastname: Celeketić
authors.forename: Radmila
authors.initials: R
authors.lastname: Blagojević
mesh_terms: D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications*
chemical_list: D004280:Dobutamine