Page 90 - Cardiac testing for coronary artery disease in potential kidney transplant recipients
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A D D I T I O N A L T A B L E S
Table 1. Description of index tests
Test Description Advantages Disadvantages Type of result Presence of cut-off
values
Screening tests
MPS This compares per- Non-invasive Neither 100% sen- Dichotomous (i.e. None. However,
Stress fusion of my- Provides sitive nor specific stress test positive or whether a stress test
Exercise ocardium at rest and information regard- Radiation dose stress test negative) is interpreted as pos-
dipyridamole after a ‘stress’ such ing functional status Results subject to itive or negative de-
dobutamine as exercise or drugs of myocardium un- interpretation and pends largely on ob-
Radionucleotide (e.g. dipyridamole). der stress conditions reader bias server interpretation
thallium-201 or Tc- False positives due
99m sestamibi ra- When coronary ar- to increase in at-
dionucleotide agents teries are normal, tenuation artefacts
‘stress’ results in va- caused by left ven-
sodilatation and in- tricularhypertrophy
creased coronary False negatives
blood flow. How- due to balanced is-
ever, diseased coro- chaemia (e.g. triple
nary arteries cannot vessel disease)
dilate because they More expensive
are already maxi- than exercise ECG
mally dilated and
there is no increase
in blood flow af-
ter a stress. MPS
reveals these areas
as regions of de-
creased perfusion. A
reversible perfusion
defect is a sign of is-
chaemia. A fixed de-
fect (when there is
decreased perfusion
before, during and
after the stress) is an
indicator of infarc-
tion
Pharmacologi-
cal agents overcome
limitations of exer-
cise testing in pa-
tients with kidney
disease
DSE Stress echocardiog- Non-invasive Neither 100% sen- Dichotomous (i.e. None. However,
Stress raphy compares the No radiation dose sitive nor specific stress test positive or whether a stress test
Exercise regional wall Provides Results subject to stress test negative) is interpreted as pos-
Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 88
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
