Preoperative risk stratification with myocardial perfusion imaging in intermediate and low-risk non-cardiac surgery

Jun Hashimoto, Tadaki Nakahara, Jingming Bai, Naoto Kitamura, Tomotaka Kasamatsu, Atsushi Kubo

Research output: Contribution to journalArticle

13 Citations (Scopus)


Background: Perioperative cardiac risk in high risk surgery is often stratified with myocardial perfusion single-photon emission computed tomography (SPECT). However, little and no data are available about intermediate and low-risk surgery, respectively. Methods and Results: A total of 1,220 consecutive patients underwent electrocardiography-gated dipyridamole stress SPECT to evaluate myocardial perfusion and cardiac function before intermediate or low risk non-cardiac surgery. Variables predictive of perioperative cardiac events were determined and the usefulness of combining pretest information and the incremental prognostic value of SPECT was estimated. The frequency of all cardiac events depended on clinical risk factors and type of surgical procedures. After sorting the patients with clinical risk factors and surgical risk, assessment of myocardial perfusion or cardiac function yielded significant risk stratification in intermediate, but not in low-risk surgery. Adding functional data to perfusion variables offered an incremental prognostic value for patients with an intermediate clinical risk and scheduled intermediate risk surgery. Conclusions: Integrating information about clinical risk factors, type of surgery, myocardial perfusion and cardiac function allows detailed preoperative risk stratification. Preoperative SPECT provides an incremental prognostic value in intermediate, but not in low-risk surgery.

Original languageEnglish
Pages (from-to)1395-1400
Number of pages6
JournalCirculation Journal
Issue number9
Publication statusPublished - 2007 Sep 13



  • Gated-single-photon emission tomography
  • Myocardial perfusion
  • Perioperative cardiac event
  • Preoperative risk stratification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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