Feasibility, safety and accuracy of dobutamine/atropine stress echocardiography for the detection of coronary artery disease in renal transplant candidates

Objective: To evaluate the feasibility, safety and accuracy of dobutamine/atropine stress echocardiography (DASE) for the detection of coronary artery desease (CAD) in renal transplant candidates. Methods: Patients candidates to renal transplant were submitted consecutively to DASE and coronary angiography The adopted angiographic criteria for CAD were an obstructive lesion of >= 50% and >= 70%. Results: 148 patients underwent the DASE and the coronary angiography. Mean age was 52 +/- 9 years, 69% of the patients were males; 27% had diabetic nephropathy and 73% had LVH; 63% were asymptomatic, 36% and 22% presented coronary obstructions >= 50% and 70%, respectively. The DASE performance was 91% and major complication rate was 2.7%. The sensibility specificity and accuracy for the diagnosis of coronary obstruction >= 50% were 53% (CI:45-61), 87% (CI:81-93), and 75% (CI:63-83) respectively. For coronary obstruction >= 70% these values were, respectively, 71% (CI:64-92), 85% (CI:79-91) and 81% (CI:75-87). The sensibility to detect univessel and multivessel disease was 41% (CI:19-63) and 78% (CI:64-92), respectively Conclusion: The DASE was practical and safe; however it presented a poor result for the detection of GAD regarding obstructions >= 50%. It can be a useful screening for the detection of CAD in candidates with obstructions >= 70% and multivessel disease.