冠状动脉计算机断层扫描血管造影用于预测高风险癌症手术患者的心肌损伤
Cristina S Bittar1,2, Isabela B Costa2, Brunna Pileggi1
1Instituto do Coração InCor, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Minerva anestesiologica
|March 4, 2025
概括
术前冠状动脉计算机断层扫描血管造影可以预测高风险手术的癌症患者的心肌损伤. 这个扫描中的高分数可以识别出患有这种并发症风险增加的患者.
科学领域:
- 心脏病学 心脏病学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 心肌损伤是手术后经常出现的并发症,特别是在高风险患者中,导致死亡率增加.
- 接受高风险手术的癌症患者面临手术后并发症的风险增加.
研究的目的:
- 确定手术前冠状动脉计算机断层扫描血管造影 (CCTA) 是否可以预测癌症患者接受高风险手术的心肌损伤.
- 评估CCTA在这个患者群体的手术风险分层中的有用性.
主要方法:
- 包括184名患有至少两种心血管风险因素的癌症患者,接受高风险手术的队列.
- 进行了手术前的CCTA,并在手术后的72小时内监测热素水平.
- 心肌损伤被定义为高灵敏度的热素T ≥0.014 ng/mL.
主要成果:
- 心肌损伤发生在48%的患者身上 (184人中有87人).
- 心肌损伤的预测因素包括膀或食道瘤,更长的麻醉时间,以及冠状动脉分数升高 (401-1000和>1000).
- 在CCTA上高分数与术后心肌损伤的发展有显著的关联.
结论:
- 冠状动脉计算机断层扫描血管造影,特别是冠状动脉分数,可以识别癌症患者在高风险手术后心肌损伤的风险较高.
- 在这一群体中,CCTA可能是手术风险分层的一个有价值的工具.
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