Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease

Bart, Bradley A., Cen, Ye-Ying, Hendel, Robert C., Lee, Ramond, Marwick, Thomas H., Missov, Emil D., Bachour, Fouad A. and Herzog, Charles A. (2009) Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease. Journal of Nuclear Cardiology, 16 4: 507-515. doi:10.1007/s12350-009-9076-y


Author Bart, Bradley A.
Cen, Ye-Ying
Hendel, Robert C.
Lee, Ramond
Marwick, Thomas H.
Missov, Emil D.
Bachour, Fouad A.
Herzog, Charles A.
Title Comparison of dobutamine stress echocardiography, dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging in patients with end-stage renal disease
Journal name Journal of Nuclear Cardiology   Check publisher's open access policy
ISSN 1071-3581
1532-6551
Publication date 2009-08-01
Sub-type Article (original research)
DOI 10.1007/s12350-009-9076-y
Volume 16
Issue 4
Start page 507
End page 515
Total pages 9
Place of publication New York, NY, U.S.A.
Publisher Springer New York LLC
Language eng
Formatted abstract
Objectives: We sought to assess and compare the diagnostic accuracy and prognostic value of dobutamine stress echocardiography (DSE), dobutamine SPECT, and adenosine SPECT myocardial perfusion imaging (MPI) in patients with end-stage renal disease (ESRD).

Background: The optimal stress imaging modality for patients with ESRD has not yet been determined.

Methods: Forty-nine patients with ESRD underwent DSE, dobutamine SPECT MPI, and adenosine SPECT MPI. The primary endpoint of the trial was concordance between stress tests with respect to the presence or absence of ischemia.

Results: Agreement on the presence or absence of ischemia between adenosine SPECT MPI and DSE was 69% (kappa 5 .25, P 5 NS). Agreement on the presence or absence of ischemia between adenosine and dobutamine SPECT MPI was 77% (kappa 5 .37, P 5 <.009). Summed stress scores for adenosine and dobutamine SPECT MPI studies were highly correlated (r 5 .9, P 5 <.0001). DSE and SPECT MPI results provided incremental prognostic information when added to clinical variables.

Conclusions:
There is moderate concordance between DSE and adenosine SPECT MPI in ESRD patients referred for stress testing. Interobserver agreement was higher for SPECT MPI compared to DSE. Based on these observations, the optimal approach for diagnosing severe coronary artery disease and assessing risk in patients with ESRD has yet to be determined, but appears to warrant further investigation.
Keyword Echocardiography
Dobutamine
Myocardial perfusion imaging :SPECT
Pharmacologic stress
Adenosine
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 03 Sep 2009, 17:50:20 EST by Mr Andrew Martlew on behalf of Medicine - Princess Alexandra Hospital