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비심장 수술 환자에서 수술 전후 심장사건의 위험도 평가를 위한 심근관류 SPECT의 유용성

Other Titles
 The Usefulness of Myocardial SPECT for the Preoperative Cardiac Risk Evaluation in Noncardiac Surgery 
 임석태  ;  이동수  ;  강원준  ;  정준기  ;  이명철 
 Korean Journal of Nuclear Medicine (대한핵의학회지), Vol.33(3) : 273-281, 1999 
Journal Title
Korean Journal of Nuclear Medicine(대한핵의학회지)
Issue Date
Cardiac risk evaluation ; Myocardial ischemia ; SPECT ; Noncardiac surgery ; T1-201 ; Tc-99m MIBI
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, $62.7{\pm}10.5$ years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-20l/ 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 ($14.6{\pm}5.6$ days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Results: Perioperative 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.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
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