비심장 수술 환자에서 수술 전후 심장사건의 위험도 평가를 위한 심근관류 SPECT 의 유용성 ( The Usefulness of Myocardial SPECT for the Preoperative Cardiac Risk Evaluation in Noncardiac Surgery ) () |
Author |
임석태(Seok Tae Lim),이동수(Dong Soo Lee),강원준(Won Jun Kang),정준기(June-Key Chung),이명철(Myung Chul Lee), |
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Affiliation |
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Abstract |
Purpose: We investigated whether myocardial SPECT had
additional usefulness to clinical, functional or
surgical indices for the preoperative evaluation of
cardiac risks in noncardiac surgery. Materials and
Methods: 118 patients (M: F=66:52, 62.7¡¾10.5 years)
were studied retrospectively. Eighteen underwent
vascular surgeries and 100 nonvascular surgeries. Rest
T1-201/stress Tc-99m-MIBI SPECT was performed before
operation and cardiac events (hard event: cardiac death
and myocardial infarction; soft event: ischemic ECG
change, congestive heart failure and unstable angina)
were surveyed through perioperative periods
(14.6¡¾5.6 days). Clinical risk indices, functional
capacity, surgery procedures and SPECT findings were
tested for their predictive values of perioperative
cardiac events. Results: Peri-operative cardiac events
occurred in 25 patients (3 hard events and 22 soft
events). Clinical risk indices, surgical procedure
risks and SPECT findings but functional capacity were
predictive of cardiac events. Reversible perfusion
decrease was a better predictor than persistent
decrease. Multivariate analysis sorted` out surgical
procedure risk (p=0.0018) and SPECT findings (p=0.0001)
as significant risk factors. SPECT could re-stratify
perioperative cardiac risks in patients ranked with
surgical procedures. Conclusion: We conclude that
myocardial SPECT provides additional predictive value
to surgical type risks as well as clinical indexes or
functional capacity for the prediction of preoperative
cardiac events in noncardiac surgery. |
Keyword |
Cardiac risk evaluation, Myocardial ischemia, SPECT, Noncardiac surgery, Tl-201, Tc-99mMIBI |
Full text Article |
28502403.pdf
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