Saito Sonoko, Takagi Atsushi, Kurokawa Fumio, Ashihara Kyomi, Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Heart Vessels. 2012 Nov;27(6):594-602. doi: 10.1007/s00380-011-0195-4. Epub 2011 Oct 12.
Guidelines have not recommended routine echocardiography to predict perioperative cardiac events (PCE). We aimed to evaluate the prognostic significance of tissue Doppler echocardiography-derived E/E' for risk stratification before noncardiac surgery. We reviewed 445 consecutive patients with cardiovascular diseases who had undergone tissue Doppler echocardiography before noncardiac surgery. The revised cardiac risk index (RCRI) was assessed from clinical records. After excluding patients who could not have E/E' measurements, 200 patients were further analyzed. PCEs included death, arrhythmia, myocardial infarction, heart failure and deferred surgery. Eleven patients developed PCEs. E/E' was significantly higher in patients with PCE (18.4 ± 5.8 vs. 12.2 ± 4.5, p < 0.0005). Multivariate analysis showed E/E' (odds ratio 1.2, p < 0.007) and RCRI (OR 4.8; 95%, p < 0.006) were independent predictors of PCE. E/E' appeared to be useful in perioperative risk stratification among patients with cardiovascular diseases undergoing noncardiac surgery.
指南未推荐采用常规超声心动图来预测围手术期心脏事件（PCE）。我们旨在评估经组织多普勒超声心动图得出的E/E'对非心脏手术前风险分层的预后意义。我们回顾了445例在非心脏手术前接受过组织多普勒超声心动图检查的心血管疾病患者。从临床记录中评估修订后的心脏风险指数（RCRI）。在排除无法进行E/E'测量的患者后, 对200例患者进行了进一步分析。PCE包括死亡、心律失常、心肌梗死、心力衰竭和延期手术。11例患者发生了PCE。发生PCE的患者E/E'显著更高（18.4±5.8 vs. 12.2±4.5, p<0.0005）。多因素分析显示E/E'（比值比1.2, p<0.007）和RCRI（OR 4.8；95%，p<0.006）是PCE的独立预测因素。E/E'似乎有助于对接受非心脏手术的心血管疾病患者进行围手术期风险分层。
