Objective

Lobectomy is an established surgical procedure for treating non-small cell lung cancer; however, it significantly impacts postoperative cardiac function. The stress electrocardiography test is relatively easy to perform and is used to confirm the presence of coronary artery stenotic lesions. However, it has a low pre-test probability and may yield many false positives. We examined the factors that would enable the appropriate selection of patients for stress electrocardiography as a preoperative cardiovascular examination preceding lobectomy for non-small cell lung cancer.

Methods

From June 2016 to July 2018, 240 patients at our institution who underwent stress electrocardiography before lobectomy for primary lung cancer were included in this study. Clinical information was extracted from electronic medical records and evaluated retrospectively. Smoking history, diabetes, hypertension, dyslipidemia, and ischemic heart disease were considered risk factors for coronary artery stenosis. We determined the coronary risk factors that were applicable to each participant and calculated the total number of coronary risk factors as a risk score.

Results

Patients with coronary risk factor scores of ≥ 3 were significantly more likely to have abnormal stress electrocardiography results. In addition, these patients also underwent more comprehensive examinations to identify coronary diseases. There were no patients with complications that could be attributed to ischemic heart disease.

Conclusion

Stress electrocardiography may be more useful before lobectomy in non-small cell lung cancer patients if the patients are appropriately selected, with the test utilized mainly in patients with coronary risk factor scores of ≥ 3.

中文翻译：

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非小细胞肺癌患者术前负荷心电图检查的选择

客观的

肺叶切除术是治疗非小细胞肺癌的既定外科手术；然而，它显着影响术后心脏功能。负荷心电图测试相对容易进行，用于确认冠状动脉狭窄病变的存在。但是，它具有较低的预测试概率，并且可能会产生许多误报。We examined the factors that would enable the appropriate selection of patients for stress electrocardiography as a preoperative cardiovascular examination preceding lobectomy for non-small cell lung cancer.

方法

2016年6月至2018年7月我院240例原发性肺癌肺叶切除术前接受负荷心电图检查的患者纳入本研究。从电子病历中提取临床信息并进行回顾性评估。吸烟史、糖尿病、高血压、血脂异常和缺血性心脏病被认为是冠状动脉狭窄的危险因素。我们确定了适用于每个参与者的冠状动脉危险因素，并计算了冠状动脉危险因素的总数作为风险评分。

结果

冠状动脉危险因素评分≥3的患者出现异常负荷心电图结果的可能性显着增加。此外，这些患者还接受了更全面的检查以识别冠状动脉疾病。没有患者出现可归因于缺血性心脏病的并发症。

结论

如果患者选择得当，负荷心电图在非小细胞肺癌患者肺叶切除术前可能更有用，该测试主要用于冠状动脉危险因素评分≥3的患者。