Department of Anaesthesia, St Vincent's Hospital, Melbourne, Australia.
J Cardiothorac Vasc Anesth. 2012 Dec;26(6):989-93. doi: 10.1053/j.jvca.2012.06.031. Epub 2012 Aug 22.
The aim of this study was to assess the risk and predictive value of cardiac pathology detected on an anesthesiologist-performed focused transthoracic echocardiogram with adverse cardiac outcomes in the perioperative period.
A retrospective review of 222 patients having a focused transthoracic echocardiogram and evaluating the incidence and echocardiographic risk factors associated with perioperative adverse cardiac events.
A single tertiary referral university teaching hospital.
Two hundred twenty patients who had a focused transthoracic echocardiogram performed by an anesthesiologist.
All patients who had a focused transthoracic echocardiogram had their discharge summary and any perioperative troponin levels reviewed, looking for evidence of adverse cardiac events, including cardiac death before discharge, myocardial infarction, pulmonary edema, hypotension requiring vasoactive drug infusion, or new arrhythmia.
Data were collected on the 222 patients who had an anesthesiologist-performed focused transthoracic echocardiogram, with 39 (18%) having an adverse cardiac event. There were 24 (11%) myocardial infarctions, 6 (2.7%) new arrhythmias, 5 (2.3%) deaths, and 4 (1.8%) episodes of severe hypotension. High-risk pathology detected on echocardiography included adverse cardiac events in 64% of the patients with pulmonary hypertension, 56% of the patients with left or right ventricular dysfunction, and 17% of the patients with stenotic valvular disease. In particular, patients with a combination of pulmonary hypertension, ventricular dysfunction, and/or stenotic valvular disease had a 77% risk of an adverse cardiac event. In contrast, no patients with a completely normal study, flow murmur, or isolated regurgitant valvular disease had adverse cardiac events.
Anesthesiologist-performed focused transthoracic echocardiography predicts perioperative adverse cardiac events in noncardiac surgical patients.
本研究旨在评估麻醉医师进行的经胸超声心动图检查中发现的心脏病理学与围手术期不良心脏结局的风险和预测价值。
对 222 例接受经胸超声心动图检查的患者进行回顾性分析，评估围手术期不良心脏事件的发生率和超声心动图危险因素。
一家单中心三级转诊教学医院。
220 例由麻醉医师进行经胸超声心动图检查的患者。
所有接受经胸超声心动图检查的患者均查阅其出院小结和任何围手术期肌钙蛋白水平，以寻找不良心脏事件的证据，包括出院前心源性死亡、心肌梗死、肺水肿、需要血管活性药物输注的低血压或新发心律失常。
共收集了 222 例接受麻醉医师进行的经胸超声心动图检查患者的数据，其中 39 例（18%）发生了不良心脏事件。24 例（11%）发生心肌梗死，6 例（2.7%）新发心律失常，5 例（2.3%）死亡，4 例（1.8%）发生严重低血压。超声心动图检测到的高危病理学包括肺动脉高压患者中 64%、左或右心室功能障碍患者中 56%和狭窄性瓣膜病患者中 17%发生不良心脏事件。特别是，同时存在肺动脉高压、心室功能障碍和/或狭窄性瓣膜病的患者发生不良心脏事件的风险为 77%。相比之下，无任何完全正常的研究、血流杂音或孤立性反流性瓣膜病的患者无不良心脏事件。
麻醉医师进行的经胸超声心动图可预测非心脏手术患者围手术期的不良心脏事件。
