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CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
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L. Cardiovascular Pharmacology
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Stress echocardiography in patients with end-stage renal disease pre and post renal transplantation - single center experience
Session:
Posters 3 - Écran 9 - Imagiologia Cardiovascular
Speaker:
Daniel Sebaiti
Congress:
CPC 2019
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
Daniel Sebaiti; Paula Fazendas; Filipa Ferreira; Alexandra Briosa; Inês Cruz; Ana ALmeida; Isabel João; Ana Rita F. Pereira; Ana Marques; Helder Pereira
Abstract
<p>Ischemic heart disease is the leading cause of mortality in patients with end stage renal disease (ESRD) candidates for renal transplantation (RT) or after RT. It is important to risk stratify this population for coronary artery disease to improve survival. The performance of stress echocardiography (SE) for adverse cardiac events has been variable in this population. The optimal non-invasive test for coronary artery disease (CAD) diagnosis in this population has yet to be established. The aim of this study was to assess the safety of SE and ability for predicting adverse cardiac events in this population.<br /> <br /> Methods: retrospective study. From January 2016 to April 2018 a total of 1245 SE were performed. We selected patients referred for risk stratification with ESRD on RT waiting list or after RT. The mean follow-up period was 18 months for major adverse cardiovascular events (MACE).<br /> <br /> Results: we studied a total of 37 patients; 26 (70,3%) were pre-RT and 11 (29,7) patients post-RT; 24 (64,9%) were male, mean age 59 years (SD 9). Risk factors: all patients had hypertension; diabetes 8 (21,6%); hyperlipidemia 23 (62,2%); overweight 9 (24,3%); history of tobacco use 19 (51,4%); previous myocardial infarction 6 (16,2%), 20 (54%) of pts had at least 3 risk factors. 46 % of pts were on beta-blockers. All pts had been on dialysis (mean duration 5 years). 16 (43,2%) pts performed exercise SE, overall they had a normal exercise tolerance: 15 pts achieved ≥ 4 METs (mean 7 METs), 9 (more than half) had an non-conclusive result; 3 had a positive test: one patient had significant CAD and underwent single vessel PCI, the second patient had diffuse coronary calcification but no significant epicardial stenosis and the third patient refused angiography. 21 patients underwent Dobutamine SE (DSE): 6 pts had a non-conclusive test result, 15 had a negative test result. One patient with negative DSE underwent angiography due to recurrent chest pain and had no significant CAD; one patient with non-conclusive result on DSE had a normal angiography. No other patients that underwent DSE had cardiac catheterization until the day of data acquisition. There were no complications of SE in this group of patients. After an average follow-up of 18 months 4 MACE occurred: 3 AMI (1 from inconclusive ESE group and 2 from inconclusive DSE group); 1 Stable angina (from de inconclusive DSE group). No need for surgical revascularization, emergency percutaneous revascularization or deaths occurred.</p> <p><br /> Conclusions: SE is a safe procedure in patients with ESRD. This population, although young, has a high cardiovascular risk burden. A significant proportion of SE are non-conclusive, this reflects either being on drugs with anti-ischemic effects (70% of patients / 46% on beta-blockers) and chronotropic incompetence common in patients with ESRD. Patients with negative tests had no MACE or need for coronary angiography on follow-up.</p>
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