Abstract

Cardiovascular disorders are the most common cause of morbidity and mortality in patients undergoing dialysis due to end-stage renal diseases accounting for approximately 50% of deaths in haemodialysed patients. The aim of our study was to evaluate the usefullness of the treadmill exercise test (TET) in detecting ischaemic heart disease (IHD) in haemodialyzed patients. Several variables were compared between the haemodialyzed patients with positive (TET ppts) and negative (TET npts) results of treadmill exercise test. Thirty seven patients (mean age 42 yrs) on maintenance haemodialysis (mean duration 29 months) were studied and 24.3% of them showed positive TET results. The TET-positive patients were significantly older with a poorer left ventricular diastolic performance (lower VmaxE, lower deceleration E) and considerably higher lipid index (triglycerides x cholesterol/HDL-chol) in comparison to TET-negative patients. We assume that these additional observations are associated with a higher ischaemic heart disease (IDH) risk in the haemodialyzed patients and seem to be helpful in selecting patients for coronarography. Evaluation of exercise tolerance in the haemodialyzed patients might also be an important indication in this invasive procedure. We believe that coronarography might be particularly indicated in the TET-positive patients on small workload ( < 5 MET) and also in those in whom adequate evaluation of the coronary reserve appears to be impossible since clinical criteria to cease the test have occured before the submaximal pulse can be reached.

Keywords: end-stage renal disease, haemodialysis, Coronary Artery Disease, lipid index, left ventricular diastolic function, treadmill exercise test