Page 92 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Table 1. Description of index tests (Continued)

nary arteries. The
calciumscore isthen
compared with a
reference range ap-
propriate to a pa-
tient’s age and sex.
High calcium scores
are associated with
higher risks of car-
diovascular events
Echocardiography An ultrasound of Provides in- Neither highly sen- Dichotomous (e.g. None
Trans-thoracic the heart that en- formation regarding sitive nor specific presence or absence
Trans-oesophageal ables assessment of myocardial function Does not provide of resting wall mo-
structure and func- and any information of tion abnormality)
tion regional wall abnor- reversible ischaemia
Impairment in sys- malities, which may Results subject to
tolic function can suggest pre-existing interpretation and
result from pre-ex- ischaemia or MI reader bias
isting CAD Enables assessment
of structure
CT coronary an- Specialised Non-invasive Radiation dose Dichotomous (i.e. Yes (i.e. ≥ 50%
giography form of CT that en- Enables diagnosis of Contrast nephropa- presence or absence stenosis or ≥ 70%
ables imaging of the precise location and thy of significant CAD) stenosis)
heart and comput- severity of each le- Inability to provide We planned to man-
erised recon- sion as opposed to opportunity age the issue of dif-
struction of coro- vascular territory af- for immediate inter- ferent cut points by
nary arteries, per- fected, as is the case vention (as opposed involving an analy-
mitting assessment for most functional to coronary angiog- sis that included:
of the lumen and tests raphy) • All studies
vessel walls Assessesnotonlythe regardless of
lumen of the ves- threshold of CAD
sel but also the wall. on coronary
It can also demon- angiography (these
strate softatheroma- will include both
tous plaques, which studies which have
cannot be demon- ≥ 50% stenosis and
strated on conven- ≥ 70% stenosis
tional coronary an- • Only studies
giography which had ≥ 70%
stenosis threshold
Cardiac magnetic MRI of the heart Non-invasive Neither highly sen- Dichotomous None
resonance imaging that enables evalua- No radiation dose sitive nor specific (e.g. presence or ab-
tion of its structure Enables assessment sence of left ven-
and function of structure of my- tricular systolic dys-
ocardium function)
High spatial reso-
lution means low

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 90
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.