TY - JOUR
T1 - Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease
AU - Rivera, Rodolfo F.
AU - Mircoli, Luca
AU - Bonforte, Giuseppe
AU - Torri, Valter
AU - Monteforte, Marta
AU - Stella, Andrea
AU - Genovesi, Simonetta
PY - 2011/10
Y1 - 2011/10
N2 - The prevalence of coronary artery disease (CAD) is high in hemodialysis (HD) patients. The aim of the study was to assess the diagnostic and prognostic value of dipyridamole stress echocardiography (DSE) in nondiabetic HD patients without signs or symptoms of CAD. In 51 out of 158 evaluated HD patients (21 females, age 67 [33-85] years, HD duration 38 [9-271] months), resting echocardiography and DSE were performed. Exclusion criteria were known CAD, diabetes mellitus, and pulmonary and oncologic pathologies. Logistic regression analysis was carried out to identify predictors of abnormal DSE response, while Cox regression analysis was performed to determine variables associated with total and cardiovascular mortality, after 43.3 (11-60) months of follow-up. Seven patients (14%) showed a positive response to DSE (DSE+). In 5/7, CAD was documented by angiography: All of them underwent coronary revascularization. DSE+ patients had significantly smaller body mass index than patients with a negative response (DSE-): 21.7±1.9 vs. 25.1±3.4kg/m 2 (p=0.018). During follow-up, 16 (31%) patients died. Older age hazard ratio [HR=1.07; confidence interval (CI)=1.01-1.12; p=0.02] and higher plasma phosphate levels (HR=10.41; CI=2.30-47.17; p
AB - The prevalence of coronary artery disease (CAD) is high in hemodialysis (HD) patients. The aim of the study was to assess the diagnostic and prognostic value of dipyridamole stress echocardiography (DSE) in nondiabetic HD patients without signs or symptoms of CAD. In 51 out of 158 evaluated HD patients (21 females, age 67 [33-85] years, HD duration 38 [9-271] months), resting echocardiography and DSE were performed. Exclusion criteria were known CAD, diabetes mellitus, and pulmonary and oncologic pathologies. Logistic regression analysis was carried out to identify predictors of abnormal DSE response, while Cox regression analysis was performed to determine variables associated with total and cardiovascular mortality, after 43.3 (11-60) months of follow-up. Seven patients (14%) showed a positive response to DSE (DSE+). In 5/7, CAD was documented by angiography: All of them underwent coronary revascularization. DSE+ patients had significantly smaller body mass index than patients with a negative response (DSE-): 21.7±1.9 vs. 25.1±3.4kg/m 2 (p=0.018). During follow-up, 16 (31%) patients died. Older age hazard ratio [HR=1.07; confidence interval (CI)=1.01-1.12; p=0.02] and higher plasma phosphate levels (HR=10.41; CI=2.30-47.17; p
KW - Cardiovascular mortality
KW - Coronary artery disease
KW - Dipyridamole stress echocardiography
KW - Hemodialysis
KW - Total mortality
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U2 - 10.1111/j.1542-4758.2011.00572.x
DO - 10.1111/j.1542-4758.2011.00572.x
M3 - Article
C2 - 22111815
AN - SCOPUS:80054888604
VL - 15
SP - 468
EP - 476
JO - Hemodialysis International
JF - Hemodialysis International
SN - 1492-7535
IS - 4
ER -