Page 49 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Ferreira 2007 (Continued)

Index and comparator tests Dobutamine/atropine stress echocardiography
• Progressive doses of dobutamine 5, 10, 20, 30 and 40 µg/kg/min, with an
increment every 3 minutes. In cases when the final objective of the evaluation had not
been reached, 0.25 mg/min atropine was added simultaneously after the third minute
of the infusion of 40 µg/kg/min of dobutamine, up to a total maximum cumulative
dose of 1 mg. The test was considered diagnostic when either 85% of the maximum for
age or echocardiographic signs of myocardial ischaemia was reached. The test was
considered non-diagnostic when there were inadequate images for the analysis (lack of
definition on ≥ 2 myocardial segments); inability to reach target stress, and premature
test withdrawal due to limiting side effects without attaining one of the test aims.
• Definitions guiding interpretation were: Normal result defined as uniform
increase of systolic movement and thickening of the left ventricular wall and
consequent reduction of its final systolic volume (global hyperdynamic response); a
positive result for myocardial ischaemia was defined as a new alteration of the reversible
segmental contractility or worsening of a pre-existing segmental alteration, in ≥ 2
contiguous myocardial segments.

Follow-up

Notes

Table of Methodological Quality

Item Authors’ judgement Description

Representative spectrum? Yes Patients with ESKD who were kidney
All tests transplant candidates undergoing cardiac
evaluation. Examinations performed one
day after haemodialysis

Acceptable reference standard? Yes Coronary angiography with a reference
All tests standard threshold of ≥ 70% stenosis

Acceptable delay between tests? Yes Not longer than 2 months.
All tests

Partial verification avoided? Yes All participants who underwent an index
All tests test also received the reference standard test

Differential verification avoided? Yes This was not an issue in this study. Disease
All tests status (CAD) is diagnosed only through
coronary angiography

Incorporation avoided? Yes This was not an issue in this study. Disease
All tests status (CAD) is diagnosed only through
coronary angiography

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 47
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.