Academic Vascular Surgical Unit, Vascular Laboratory, Hull Royal Infirmary, Hull York Medical School, University of Hull, Anlaby Road, Hull, HU3 2JZ, UK.
World J Surg. 2013 May;37(5):1169-73. doi: 10.1007/s00268-013-1939-3.
To determine whether resting pre-operative left ventricular ejection fraction (LVEF) estimated by multiple gated acquisition scanning (MUGA) predicts long-term survival in patients undergoing elective abdominal aortic aneurysm (AAA) repair.
A retrospective study of MUGA scans which were performed to estimate pre-operative resting LVEF in 127 patients [106 (83 %) males, mean age 74 ± 7.6 years] who underwent elective AAA repair over a period of 4 years from March 2007. We compared outcomes and long-term survival between patients who had a pre-operative LVEF ≤ 40 % (Group 1, n = 60) and LVEF > 40 % (Group 2, n = 67).
Overall 19 (15 %) patients died during the follow-up period (13 patients in group 1 and 6 patients in group 2). 30-day mortality was 8 %. There was no significant difference between group 1 and 2 in terms of patients' mean age or median length of hospital stay (8 days for both groups, p = 0.61). However, group 2 had more females than group 1(18 vs. 3, p = 0.001). Median survival for patients in group 2 was significantly higher than patients in group 1 (1,258 days vs. 1,000 days, p = 0.03). In a Cox regression model which included age, sex, smoking status and LVEF as covariates, only smoking status and LVEF predicted survival [Hazard ratio (HR) = 1.06, p = 0.04 and HR = 0.93, p = 0.00, respectively].
This study shows that there is a role for pre-operative MUGA scan assessment of resting LVEF in predicting long-term survival post elective AAA repair and that the lower the pre-operative LVEF the poorer the long-term outcome.
确定通过门控采集扫描（MUGA）评估的术前左心室射血分数（LVEF）是否可以预测择期腹主动脉瘤（AAA）修复患者的长期生存率。
回顾性分析了在 2007 年 3 月至 4 年内进行的 127 例（106 例男性，平均年龄 74±7.6 岁）择期 AAA 修复患者的 MUGA 扫描，以评估术前静息 LVEF。我们比较了术前 LVEF≤40%（组 1，n=60）和 LVEF＞40%（组 2，n=67）患者的结果和长期生存率。
在随访期间，共有 19 例（15%）患者死亡（组 1 中有 13 例，组 2 中有 6 例）。30 天死亡率为 8%。组 1 和组 2 的患者平均年龄或中位住院时间无显著差异（两组均为 8 天，p=0.61）。然而，组 2 的女性多于组 1（18 比 3，p=0.001）。组 2 患者的中位生存时间明显高于组 1（1258 天比 1000 天，p=0.03）。在包括年龄、性别、吸烟状况和 LVEF 作为协变量的 Cox 回归模型中，只有吸烟状况和 LVEF 预测了生存率[风险比（HR）=1.06，p=0.04 和 HR=0.93，p=0.00，分别]。
本研究表明，术前 MUGA 扫描评估静息 LVEF 在预测择期 AAA 修复后的长期生存率方面具有一定作用，术前 LVEF 越低，长期预后越差。
