title: Comparison of left ventricular function and myocardial perfusion for evaluating perioperative cardiac risk of abdominal aortic surgery.
abstract: The measurement of left ventricular function by gated blood pool scanning and of myocardial perfusion by dipyridamole thallium imaging were compared in a prospective study of patients who had abdominal aortic aneurysm or aortoiliac occlusive disease to determine which measurement was the better predictor of postoperative cardiac complications. Sixty-six men and 19 women (mean age 67 years) underwent both tests before admission for surgery. Fifty-six had repair of an abdominal aortic aneurysm, and 29 had reconstruction for aortoiliac occlusive disease. In 17 patients the left ventricular ejection fraction was less than 50%. Dipyridamole thallium imaging was positive, showing redistribution, in 45 patients. Postoperative cardiac complications occurred in 33 patients. The sensitivity of dipyridamole thallium imaging (91%) was significantly (p less than 0.01) greater than that observed with gated blood pool scanning (27%). However, the specificity of gated blood pool scanning (85%) was similar to that of dipyridamole thallium imaging (71%). Diagnostic accuracy was greatest with dipyridamole thallium imaging (79% versus 62% [p less than 0.02]). Dipyridamole thallium imaging is superior to gated blood pool scanning for perioperative evaluation of vascular surgical patients.
authors.affiliation: Division of Vascular Surgery, Ottawa Civic Hospital, University of Ottawa, Ont.
authors.forename: N V
authors.initials: NV
authors.lastname: McPhail
authors.forename: T D
authors.initials: TD
authors.lastname: Ruddy
authors.forename: J E
authors.initials: JE
authors.lastname: Calvin
authors.forename: G G
authors.initials: GG
authors.lastname: Barber
authors.forename: C W
authors.initials: CW
authors.lastname: Cole
authors.forename: R A
authors.initials: RA
authors.lastname: Davies
authors.forename: K Y
authors.initials: KY
authors.lastname: Gulenchyn
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000601:surgery; D004176:Dipyridamole; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D011446:Prospective Studies; D013318:Stroke Volume; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes; D004176:Dipyridamole