| Journal: | Arquivos brasileiros de cardiologia |
| Database: | PERIÓDICA |
| System number: | 000289156 |
| ISSN: | 0066-782X |
| Authors: | Ferreira, Pedro Antonio Muniz1 Lima, Valter Correia de1 Campos-Filho, Orlando1 Gil, Manuel Adan1 Cordovil, Adriana1 Machado, Cristiano Vieira1 Pestana, Jose Osmar Medina1 Carvalho, Antonio Carlos de Camargo1 |
| Institutions: | 1Universidade Federal de Sao Paulo, Escola Paulista de Medicina, Sao Paulo. Brasil |
| Year: | 2007 |
| Season: | Ene |
| Volumen: | 88 |
| Number: | 1 |
| Pages: | 45-51 |
| Country: | Brasil |
| Language: | Portugués, inglés |
| Document type: | Estadística o encuesta |
| Approach: | Analítico |
| English abstract | OBJECTIVE: To evaluate the feasibility, safety and accuracy of dobutamine/atropine stress echocardiography (DASE) for the detection of coronary artery desease (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 > 50% and > 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 > 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 > 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. CONCLUSION: The DASE was practical and safe; however, it presented a poor result for the detection of CAD regarding obstructions > 50%. It can be a useful screening for the detection of CAD in candidates with obstructions > 70% and multivessel disease |
| Portuguese abstract | OBJETIVO: Avaliar a exeqüibilidade, a segurança e a acurácia diagnóstica do ecocardiograma sob estresse (EEDA) com dobutamina/atropina em candidatos a transplante renal. MÉTODOS: Pacientes candidatos a transplante renal com e sem nefropatia diabética realizaram EEDA e cineangiocoronariografia. Consideraram-se dois pontos de corte para doença arterial coronariana (DAC): > 50% e > 70% de obstrução de uma artéria epicárdica. RESULTADOS: Cento e quarenta e oito pacientes realizaram o EEDA e a angiografia coronariana. A média de idade foi de 52±9 anos, 69% eram do sexo masculino, 27% tinham nefropatia diabética, e 73%, HVE; 63% estavam assintomáticos, 36% e 22% apresentaram obstruções coronarianas > 50% e > 70%, respectivamente. A exeqüibilidade foi de 91% e houve 2,7% de complicações maiores. Obtiveram-se as seguintes médias de sensibilidade, especificidade e acurácia, considerando obstrução coronariana > 50%: 53% (IC:45-61), 87% (IC:81-93), e 75% (IC:63-83), respectivamente. Para obstrução >70%, 71% (IC:64-92), 85% (IC:79-91) e 81% (IC:75-87). A sensibilidade para diagnosticar doença uniarterial foi 41% (IC:19-63) e doença multiarterial, 78% (IC:64-92). CONCLUSÃO: O EEDA foi exeqüível e seguro; entretanto, foi ineficiente para rastreamento de DAC, considerando obstruções > 50%, mas pode ser útil para detecção de DAC em pacientes com obstruções > 70% e doença multiarterial |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Nefrología, Sistema cardiovascular, Ecocardiografía, Enfermedad coronaria, Insuficiencia renal crónica (IRC) |
| Keyword: | Medicine, Cardiovascular system, Diagnosis, Nephrology, Echocardiography, Coronary artery disease, Chronic renal failure (CRF) |
| Full text: | Texto completo (Ver HTML) |
