1996 Volume 29 Issue 10 Pages 1371-1378
We demonstrated the usefulness of the dipyridamole ECG test (DP-ECG) for evaluating ischemic heart disease (IHD) in patients with chronic renal failure (CRF).
Twenty-four patients (17 males and 7 females, mean age 60±10 years) were studied; the underlying renal diseases were chronic glomerulonephritis in 8 patients, diabetic nephropathy in 4, nephrosclerosis in 4 and miscellaneous disorders in 4. Two of the patients were managed conservatively, 20 were on HD, and 2 were on CAPD. As to complications pertaining to heart disease, 14 had angina pectoris, 7 had acute myocardial infarction, and 3 had old myocardial infarction. For DP-ECG, we injected 0.6mg/kg of dipyridamole intravenously over 4 minutes, and obtained ECG's prior to injection and at 0, 5, 10 and 15 minutes after administration, with additional ECG's taken if necessary. We considered 0.1mV ST segment depression to represent an abnormal ECG. All patients were examined by standard coronary angiography (CAG).
During DP-ECG, 7 patients suffered an anginal attack and 6 had an abnormal ECG without chest pain. These patients were considered to be DP-ECG positive, and the remainder to be DP-ECG negative. By CAG, 11 of the 13 DP-ECG positive patients had significant vessel disease, whereas only 2 of the 11 negative DP-ECG patients showed vessel disease. Accordingly, the sensitivity of DP-ECG was 84.6%, the specificity 81.8%, and the accuracy 83.8%. All angina attacks observed in 7 patients were quickly reversed by intravenous theophylline iniection. Therefore, we conclude that DP-ECG is useful for evaluating significant coronary stenosis in CRF patients with IHD.
