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Published on: February 10, 2013

Prognostic value of dobutamine stress echocardiography in patients with chronic kidney disease

Sébastien Bergeron1, Graham S Hillis, Eric N Haugen

  • 1Division of Cardiovascular Diseases, Mayo Clinic Rochester, MN 55905, USA.

American Heart Journal
|February 20, 2007
PubMed

Insights

Dobutamine stress echocardiography (DSE) can predict mortality in chronic kidney disease (CKD) patients. The extent of myocardial ischemia identified by DSE independently predicts all-cause mortality in CKD.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Diagnostics

Background:

  • Dobutamine stress echocardiography (DSE) is recommended for evaluating chronic kidney disease (CKD) patients.
  • Limited data exist on the prognostic value of DSE in CKD patients.

Purpose of the Study:

  • To assess the prognostic utility of DSE in patients with CKD.
  • To determine if DSE can predict mortality in this population.

Main Methods:

  • 485 CKD patients (on dialysis or creatinine > 3 mg/mL) underwent DSE.
  • Patients were followed for 2.3 +/- 1.8 years for mortality outcomes.

Main Results:

  • 39% of patients died during follow-up.
  • Extensive ischemia (>25% segments) on DSE was associated with significantly lower survival rates.
  • The percentage of ischemic segments was an independent predictor of all-cause mortality (HR 1.40 per 25% increase, P=.001).
  • DSE improved the predictive value of clinical models (chi2, 83.6-97.4, P=.003).

Conclusions:

  • DSE is a valuable prognostic tool in CKD patients.
  • The percentage of ischemic segments on DSE independently predicts mortality.
  • DSE provides incremental prognostic information beyond clinical data in CKD.
Abstract

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