TY - JOUR
T1 - Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease
AU - Bergeron, Sébastien
AU - Hillis, Graham S.
AU - Haugen, Eric N.
AU - Oh, Jae K.
AU - Bailey, Kent R.
AU - Pellikka, Patricia A.
N1 - Funding Information:
Dr Bergeron was supported by a grant from Laval University, Quebec, Canada, and Dr Hillis by a grant from the British Heart Foundation. The study was supported by a grant from the Mayo Foundation.
PY - 2007/3
Y1 - 2007/3
N2 - Background: Although dobutamine stress echocardiography (DSE) is cited in clinical guidelines for the evaluation of patients with chronic kidney disease (CKD), there are limited data regarding its prognostic utility in this setting. The current study assesses the prognostic value of DSE in patients with CKD. Methods: Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results: One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model (χ2, 83.6-97.4; P = .003). Conclusion: In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data.
AB - Background: Although dobutamine stress echocardiography (DSE) is cited in clinical guidelines for the evaluation of patients with chronic kidney disease (CKD), there are limited data regarding its prognostic utility in this setting. The current study assesses the prognostic value of DSE in patients with CKD. Methods: Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results: One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model (χ2, 83.6-97.4; P = .003). Conclusion: In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data.
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U2 - 10.1016/j.ahj.2006.11.012
DO - 10.1016/j.ahj.2006.11.012
M3 - Article
C2 - 17307417
AN - SCOPUS:33847292348
SN - 0002-8703
VL - 153
SP - 385
EP - 391
JO - American heart journal
JF - American heart journal
IS - 3
ER -