Benefits of quantitative gated SPECT in evaluation of perioperative cardiac risk in noncardiac surgery
| Autor: | Koji Watanabe, Hirohiko Abe, Masahito Hattori, Shinya Minatoguchi, Hisayoshi Fujiwara, Yukio Ohsumi |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty 99mTc-tetrofosmin Gated SPECT Risk Assessment Sensitivity and Specificity Perioperative Care Postoperative Complications Risk Factors Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Cardiac risk Aged Aged 80 and over Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Reproducibility of Results Gated Blood-Pool Imaging General Medicine Perioperative Middle Aged Prognosis Treatment Outcome Cardiovascular Diseases cardiovascular system Cardiology Female Radiology business Noncardiac surgery Emission computed tomography |
| Zdroj: | Annals of Nuclear Medicine. 21:563-568 |
| ISSN: | 1864-6433 0914-7187 |
| DOI: | 10.1007/s12149-007-0070-7 |
| Popis: | Gated single-photon emission computed tomography (G-SPECT) was used to evaluate cardiac risk associated with noncardiac surgery and determine the benefits and indications of this technique for this type of surgery.Patients scheduled to undergo noncardiac surgery under the supervision of anesthesiologists and subjected to preoperative cardiac evaluation using G-SPECT during the 26-month period between June 2000 and August 2002 were followed for the presence/absence of cardiac events (i.e., cardiac death, myocardial infarction, unstable angina, congestive heart failure, or fatal arrhythmia) during surgery and the postoperative period until discharged. Relationships between the occurrence of cardiac events and preoperative G-SPECT findings were evaluated.A total of 39 patients underwent G-SPECT; 6 of the 39 exhibited abnormal ejection fraction (left ventricular ejection fraction, LVEFor=50%) and end-systolic volume (ESVor=50 ml). Surgery was suspended for three of these six patients and cardiac events developed in the remaining three patients. Both abnormal perfusion images (PI) and abnormal wall thickening (WT) were observed in all six patients. All six patients exhibited abnormal LVEF and/or ESV. Three patients had either abnormal PI or WT, and a cardiac event occurred in one of them. Of the five patients who experienced cardiac events during or after surgery, two exhibited a short run of ventricular tachycardia requiring a continuous administering of antiarrhythmic drugs, whereas the remaining three patients exhibited cardiac failure requiring inotropic support following surgery.The results of this study indicate that the occurrence of perioperative cardiac events can be predicted by considering the severity of expected surgical stress and preoperative G-SPECT findings for LVEF, PI, and WT. We conclude that G-SPECT is quite useful for cardiac risk assessment in patients undergoing noncardiac surgery. |
| Databáze: | OpenAIRE |
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