Skeletal muscle blood flow in heart failure measured by ultrafast computed tomography: validation by comparison with plethysmography.
OBJECTIVE
Abnormalities of skeletal muscle perfusion and metabolism may be important in the symptomatic limitation of patients with chronic heart failure. A method for assessing both skeletal muscle blood flow and mass would be useful in clinical practice and research. Ultrafast computed tomography has the potential to make these measurements. The aim was to determine the accuracy with which skeletal muscle blood flow could be measured by ultrafast computed tomography in patients with chronic heart failure.


METHODS
Leg blood flow measured by venous occlusion plethysmography was compared with skeletal muscle blood flow by ultrafast computed tomography. Fourteen patients with chronic heart failure (aged 51 to 76 years) were investigated. Plethysmography and ultrafast computed tomography measurements were performed at rest and during hyperaemic flow induced by symptom limited bicycle exercise followed by five minutes of leg ischaemia. The ultrafast computed tomography measurements were made by analysing the opacification of the blood pool and of the muscle after an intravenous bolus of non-ionic radio-opaque contrast.


RESULTS
Flows assessed by plethysmography ranged from 1.5 to 38.1 ml x 100 ml-1 x min-1. The slope of the line relating the two methods was 1.1 (95% confidence interval 0.91 to 1.31), and the mean (95% limits of agreement) of the differences between the two methods was 2.5(10.6) ml x 100 ml-1 x min-1.


CONCLUSIONS
Ultrafast computed tomography is a useful tool in the measurement of both skeletal muscle mass and perfusion in humans.
Ludman
P F
PF
Royal Brompton National Heart and Lung Hospital, London, United Kingdom.
Volterrani
M
M
Clark
A L
AL
Poole-Wilson
P A
PA
Rees
S
S
Coats
A J
AJ
D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000098:blood supply* / Q000000981:diagnostic imaging; D010991:Plethysmography; D014057:Tomography, X-Ray Computed / Q000379:methods*