Page 91 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Table 1. Description of index tests (Continued)

dobutamine motion and thick- information regard- interpretation and itive or negative de-
ness of myocardium ing functional status reader bias pends largely on ob-
both at rest and af- of myocardium un- Operator server interpretation
ter stress. Regional der stress conditions dependent
systolic dysfunction Provides assessment Acoustic windows
is usually caused by of ventricular size not possible in up to
CAD and function 20% of subjects
Pharmacologi- Hyper-
cal stress agent over- tensive response to
comes limitations of stress agent possible
exercise testing in Cardiomyopathies
patients with kidney may also show re-
disease gional variation in
function
Exercise ECG Patient exercises on Non-invasive Neither 100% sen- Dichotomous (i.e. No. However,
Bruce protocol stress a Provides sitive nor specific stress test positive or whether a stress test
ECG treadmill while con- information regard- Results subject to stress test negative) is interpreted as pos-
nected to an ECG. ing functional status interpretation and itive or negative de-
The level of exercise of myocardium un- reader bias pends largely on ob-
is increased in pro- der stress conditions Often limited by the server interpretation
gressive stages. The inabil-
patient’s symptoms ity of CKD patients
and blood pressure to achieve an ade-
response are quate peak exercise
checked repeatedly. workload, develop-
Ischaemic ECG ment of exercise-in-
changes or angina duced hypotension
symptoms brought High pro-
on by exercise are portion have abnor-
highly suggestive of mal baseline ECG
underlying CAD (left ventricular hy-
pertrophy)

Coronary artery Car- Non-invasive Neither 100% sen- Continuous There is no uni-
calcium score diac calcium scoring sitive nor specific formly agreed cut-
EBCT is a non-invasive test Radiation dose off value at which
Multidetector com- that uses computed patients are consid-
puted tomography tomography to de- ered at high risk of
tect the presence of CAD. We planned
calcium in plaque to analyse results
on the walls of the by combining data
arteries of the heart from studies which
(coronary arteries). share identical cut-
A calcium score is off values
then derived, calcu-
lated as a summa-
tion of all calcified
lesions in the coro-

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 89
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.