수술 전 심장기능 평가에 있어 심근관류 SPECT의 유용성 = The Usefulness of Cardiac SPECT for the Preoperative Cardiac Evaluation

다국어 초록 (Multilingual Abstract)

Background/Aims: The preoperative cardiac evaluation is important to predict perioperative cardiac event in patients who planned for non-cardiac operation. However, the usefulness of cardiac SPECT and/or evaluation of patient with clinical criteria is not clear. Therefore we evaluate the prognostic value of cardiac SPECT in surgical patients. And also compare the result of clinical risk stratification using the ACC/AHA guidelines with those of cardiac SPECT.
Methods: 75 patients(M:F=31:44, 62.8±9.2 years), who have chest pain, EKG abnormality or history of ischemic heart disease were enrolled to the study. According to the result of cardiac SPECT, they were divided to 3 groups: normal perfusion(n=51), reversible perfusion defect(n=31), irreversible perfusion defect(n=3). Also we divided 3 groups according to clinical predictors of the ACC/AHA guidelines: minor risk group(n=51), intermediate risk group(n=21), and major risk group(n=3). I compare predictive power of perioperative cardiac event between cardiac SPECT and clinical predictors of the ACC/AHA guidelines.
Results: Cardiac event occurred in 9.2% of patient. Prevalence of cardiac event in reversible cardiac perfusion group(19.0%) and irreversible cardiac perfusion group(33.3%) was higher than normal group(3.8%)(p〈0.05). By clinical predictors according to the ACC/AHA guidelines, I could not predict the postoperative cardiac event.
Conclusion: Cardiac SPECT is more useful than clinical predictors according to the ACC/AHA guidelines in preoperative cardiac evaluation in patients with chest pain, EKG abnormality or history of ischemic heart disease.