Extravascular lung water measured with 99mTc-RBC and 99mTc-DTPA is increased in left-sided heart failure.
Extravascular lung water (EVLW) was quantitatively measured in 81 patients consisting of 10 subjects with normal cardiac function and 71 patients with left-sided heart diseases, using 99mTc-RBC as a non-diffusible indicator and 99mTc-DTPA as a diffusible indicator in the equilibrium phase. EVLW averaged 3.0 +/- 1.4 (ml/kg, mean +/- SD) in subjects with normal cardiac function (n = 10), 4.3 +/- 1.7 in New York Heart Association functional class I patients (n = 30), 4.8 +/- 2.4 in NYHA functional class II patients (n = 33) and 9.4 +/- 5.4 in NYHA functional class III (n = 8) patients. EVLW was greater in NYHA class III than in normal controls or NYHA classes I or II (p < 0.01). Lung thermal volume (LTV) was also measured in 31 of the 81 patients using a double indicator dilution technique with sodium and heat. LTV averaged 6.0 +/- 1.2 (ml/kg) in normal subjects (n = 4), 8.6 +/- 2.0 in NYHA functional class I patients (n = 11), 9.7 +/- 3.0 in NYHA functional class II patients (n = 13), and 15.9 +/- 8.2 in NYHA functional class III patients (n = 3). The correlation between EVLW and LTV was significant (EVLW = 0.79 x LTV - 72.8, r = 0.80, p < 0.01). There were significant differences in EVLW/LTV ratio between NYHA class III (0.93 +/- 0.16) and NYHA class I (0.62 +/- 0.22). Thus, it was shown that EVLW was increased in left-sided heart failure and that LTV overestimated the EVLW.
Nawada
M
M
Second Department of Internal Medicine, Gifu University School of Medicine, Japan.
Gotoh
K
K
Yagi
Y
Y
Ohshima
S
S
Yamamoto
N
N
Deguchi
F
F
Sawa
T
T
Tanaka
H
H
Yamaguchi
M
M
Uemura
H
H
D000368:Aged; D002303:Cardiac Output, Low / Q000503:physiopathology*; D004912:Erythrocytes; D015633:Extravascular Lung Water / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013667:Technetium; D016284:Technetium Tc 99m Pentetate
D013667:Technetium; D016284:Technetium Tc 99m Pentetate