Comparison of dobutamine stress echocardiography and ECG for screening of coronary artery disease in high- risk hemodialysis patients

ABSTRACT

To compare the results of dobutamine stress echocardiography [DSE] as a sensitive and specific, non-invasive test for screening of coronary artery disease [CAD] in end-stage renal disease hemodialysis patients with the results of ECG. Thirty nine patients at high-risk for CAD by definition were studied. Coronary artery risk factors including age, sex, hypertension, hyperlipidemia and hyperglycemia were reviewed. ECG, chest x-ray [CXR], Echocardiography [Echo] and DSE were done in all. The results showed that 10 out of 11 patients with a normal ECG had negative DSE [npv = 91%] and 9 out of 26 patients with any abnormal ECG had positive DSE [ppv = 35%]. On the other hand 19 out of 26 patients without symptoms of CAD had negative DSE [npv = 73%] and 3 out of 11 patients with symptoms of CAD had positive DSE [ppv = 27%]. Even in high-risk HD patients a normal ECG can reliably predict a normal DSE. Also any abnormal ECG would emphasize on the need for further CAD screening by DSE