Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease
Background Although dobutamine stress echocardiography (DSE) is cited in clinical guidelines for the evaluation of patients with chronic kidney disease (CKD), there are limited data regarding its prognostic utility in this setting. The current study assesses the prognostic value of DSE in patients w...
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| Veröffentlicht in: | The American heart journal 2007-03, Vol.153 (3), p.385-391 |
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| creator | Bergeron, Sébastien, MD Hillis, Graham S., MBChB, PhD Haugen, Eric N., MD Oh, Jae K., MD Bailey, Kent R., PhD Pellikka, Patricia A., MD |
| description | Background Although dobutamine stress echocardiography (DSE) is cited in clinical guidelines for the evaluation of patients with chronic kidney disease (CKD), there are limited data regarding its prognostic utility in this setting. The current study assesses the prognostic value of DSE in patients with CKD. Methods Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model ( χ2 , 83.6-97.4; P = .003). Conclusion In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data. |
| doi_str_mv | 10.1016/j.ahj.2006.11.012 |
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The current study assesses the prognostic value of DSE in patients with CKD. Methods Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model ( χ2 , 83.6-97.4; P = .003). Conclusion In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2006.11.012</identifier><identifier>PMID: 17307417</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular system ; Chronic Disease ; Comorbidity ; Coronary Disease - diagnostic imaging ; Coronary Disease - epidemiology ; Coronary Disease - mortality ; Diabetes ; Echocardiography, Stress ; Female ; Heart ; Heart attacks ; Heart rate ; Humans ; Hypertension ; Investigative techniques, diagnostic techniques (general aspects) ; Ischemia ; Kidney diseases ; Kidney Diseases - epidemiology ; Kidney Diseases - etiology ; Kidney Diseases - surgery ; Kidney Transplantation ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Peritoneal dialysis ; Prognosis ; Renal failure ; Risk factors ; Stroke Volume ; Ultrasonic investigative techniques ; Urinary system involvement in other diseases. Miscellaneous</subject><ispartof>The American heart journal, 2007-03, Vol.153 (3), p.385-391</ispartof><rights>Mosby, Inc.</rights><rights>2007 Mosby, Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Limited Mar 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-8d1af3eab09c4b0bcfcbd10abaf66747b84ec05201bb73cc919ac2b2c6f455f03</citedby><cites>FETCH-LOGICAL-c464t-8d1af3eab09c4b0bcfcbd10abaf66747b84ec05201bb73cc919ac2b2c6f455f03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504618394?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994,64384,64386,64388,72340</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19106817$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17307417$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bergeron, Sébastien, MD</creatorcontrib><creatorcontrib>Hillis, Graham S., MBChB, PhD</creatorcontrib><creatorcontrib>Haugen, Eric N., MD</creatorcontrib><creatorcontrib>Oh, Jae K., MD</creatorcontrib><creatorcontrib>Bailey, Kent R., PhD</creatorcontrib><creatorcontrib>Pellikka, Patricia A., MD</creatorcontrib><title>Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Although dobutamine stress echocardiography (DSE) is cited in clinical guidelines for the evaluation of patients with chronic kidney disease (CKD), there are limited data regarding its prognostic utility in this setting. The current study assesses the prognostic value of DSE in patients with CKD. Methods Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model ( χ2 , 83.6-97.4; P = .003). Conclusion In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Chronic Disease</subject><subject>Comorbidity</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - mortality</subject><subject>Diabetes</subject><subject>Echocardiography, Stress</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ischemia</subject><subject>Kidney diseases</subject><subject>Kidney Diseases - epidemiology</subject><subject>Kidney Diseases - etiology</subject><subject>Kidney Diseases - surgery</subject><subject>Kidney Transplantation</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Peritoneal dialysis</subject><subject>Prognosis</subject><subject>Renal failure</subject><subject>Risk factors</subject><subject>Stroke Volume</subject><subject>Ultrasonic investigative techniques</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kt-L1DAQx4so3t7pH-CLFMR7a51ps2mLIMjhLzhQUMEnQzKdXtPrNntJe7L_vVl3YeEefAqBz3yZ-cwkyQuEHAHlmyHX_ZAXADJHzAGLR8kKoakyWQnxOFkBQJHVFZRnyXkIQ_zKopZPkzOsSqgEVqvk9zfvbiYXZkvpvR4XTl2Xts4ss97YidMwew4hZeodad9ad-P1tt-ldkq3erY8zSH9Y-c-pd67KYbc2nbiXdrawDrws-RJp8fAz4_vRfLz44cfV5-z66-fvly9v85ISDFndYu6K1kbaEgYMNSRaRG00Z2Ms1SmFkywLgCNqUqiBhtNhSlIdmK97qC8SC4PuVvv7hYOs9rYQDyOemK3BCUbKIQsqwi-egAObvFT7E3hGoTEumxEpPBAkXcheO7U1tuN9juFoPbq1aCierVXrxBVVB9rXh6TF7Ph9lRxdB2B10dAB9Jj5_VENpy4BkHW_7i3B46jsHvLXgWKoolb65lm1Tr73zbePaim0cbF6PGWdxxO06pQKFDf9zeyPxGQgCDKX-Vfcku3TA</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Bergeron, Sébastien, MD</creator><creator>Hillis, Graham S., MBChB, PhD</creator><creator>Haugen, Eric N., MD</creator><creator>Oh, Jae K., MD</creator><creator>Bailey, Kent R., PhD</creator><creator>Pellikka, Patricia A., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20070301</creationdate><title>Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease</title><author>Bergeron, Sébastien, MD ; Hillis, Graham S., MBChB, PhD ; Haugen, Eric N., MD ; Oh, Jae K., MD ; Bailey, Kent R., PhD ; Pellikka, Patricia A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-8d1af3eab09c4b0bcfcbd10abaf66747b84ec05201bb73cc919ac2b2c6f455f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular system</topic><topic>Chronic Disease</topic><topic>Comorbidity</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - mortality</topic><topic>Diabetes</topic><topic>Echocardiography, Stress</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ischemia</topic><topic>Kidney diseases</topic><topic>Kidney Diseases - epidemiology</topic><topic>Kidney Diseases - etiology</topic><topic>Kidney Diseases - surgery</topic><topic>Kidney Transplantation</topic><topic>Kidneys</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Peritoneal dialysis</topic><topic>Prognosis</topic><topic>Renal failure</topic><topic>Risk factors</topic><topic>Stroke Volume</topic><topic>Ultrasonic investigative techniques</topic><topic>Urinary system involvement in other diseases. 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The current study assesses the prognostic value of DSE in patients with CKD. Methods Four hundred eighty-five patients with CKD (on renal dialysis or with creatinine >3 mg/mL) who had DSE were followed for 2.3 ± 1.8 years. Results One hundred eighty-eight (39%) patients died during follow-up. Patients with extensive ischemia (affecting >25% of myocardial segments) had a 1- and 3-year survival rate of 77% and 48%, respectively, compared with 83% and 52% in those with lesser degrees (≤25% segments affected) of ischemia and with 88% and 70% in those with a normal DSE. In multivariate analyses, the percentage of ischemic segments on DSE was an independent predictor of all-cause mortality (hazard ratio, 1.40 per 25% increase; 95% CI, 1.16-1.68; P = .001). Inclusion of DSE data improved the predictive value of the best clinical model ( χ2 , 83.6-97.4; P = .003). Conclusion In patients with CKD, the percentage of ischemic segments during DSE is an independent predictor of mortality and provides prognostic information that is incremental to clinical data.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>17307417</pmid><doi>10.1016/j.ahj.2006.11.012</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular system Chronic Disease Comorbidity Coronary Disease - diagnostic imaging Coronary Disease - epidemiology Coronary Disease - mortality Diabetes Echocardiography, Stress Female Heart Heart attacks Heart rate Humans Hypertension Investigative techniques, diagnostic techniques (general aspects) Ischemia Kidney diseases Kidney Diseases - epidemiology Kidney Diseases - etiology Kidney Diseases - surgery Kidney Transplantation Kidneys Male Medical sciences Middle Aged Mortality Multivariate Analysis Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Peritoneal dialysis Prognosis Renal failure Risk factors Stroke Volume Ultrasonic investigative techniques Urinary system involvement in other diseases. Miscellaneous |
| title | Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease |
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