대한핵의학회지 (1967년~2009년)
대한핵의학회지 1997;31(1)43~7
원저 : 게이트 심근 SPECT의 관동맥우회로술후 심근 벽운동 호전 예측능 ( Predictive Values of Gated Myocardial SPECT for Wall Motion Improvement After Bypass Surgery )
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Author 이동수(Dong Soo Lee),윤석남(Seok Nam Yoon),송호천(Ho Cheon Song),김기봉(Ki Bong Kim),정준기(June Key Chung),이명묵(Myoung Mook Lee),이명철(Myung Chul Lee),고창순(Chang Soon Koh),
Affiliation
Abstract

Though myocardial perfusion was usually expected to improve after coronary artery bypass graft(CABG) surgery, some myocardial segments were aggravated after operation, as we compared perfusion changes on postoperative SPECT with preoperative ones. In this study, we evaluated perfusion changes after operation in rest and stress myocardial SPECT in 44 patients (M:F=25:19, age 57.1 year±8.2) who had CABG before and 3 months after operation. We tried to find out possible causes for perfusion aggravation with multivariate logistic regression analysis regarding whether bypass graft was artery or vein and which coronary artery territory was operated. Among 616 myocardial segments which were operated, 89(14.4%) aggravated after operation. In the univariate analysis, myocardial segments in the left circumflex arteries(LCx) aggravated more often(p〈0.0l) than others and segments having operative angioplasty did less often(p〈0.0l). Multivariate logistic regression revealed that LCx was risk factor for perfusion aggravation [odds ratio=2.54 (95% confidence interval : 1.53-4.22, p〈0.01)]. However, this was not the case when we analysed in terms of arterial territories. Among 106 coronary arterial territories which were operated, 27(25.5%) aggravated. The territories having aggravated had similar characteristics regarding whether they received arterial or venous grafts, angioplasty and whether the operated territories were left anterior descending, right coronary or left circumflex arteries. In conclusion, myocardial segments in the left circumflex artery tended to aggravate more often after bypass surgery than the others. In short-term comparison of perfusion after surgery, we could not find any tendency that arterial or venous graft was associated with more frequency of the aggravation of perfusion after operation.

Keyword Gated SPECT, systolic thickening, coronary artery bypass graft, wall motion, viability
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