Correlation of a scintigraphic pulmonary perfusion index with hemodynamic parameters in patients with pulmonary arterial hypertension.
OBJECTIVE
To determine whether the perfusion index (PI) can be used as a noninvasive measure to diagnose and predict the severity of disease in patients with pulmonary arterial hypertension (PAH).


METHODS
Twenty-two patients were included in this retrospective investigation: 9 controls and 13 patients with PAH. Controls had no evidence of PAH [mean pulmonary arterial pressure (MPAP) ≤25 mm Hg and pulmonary capillary wedge pressure ≤18 mm Hg]. The study patients had PAH (MPAP ≥25 mm Hg and pulmonary capillary wedge pressure ≤18 mm Hg) and no diagnosis of pulmonary embolism. Due to the retrospective nature of the study, the PI was calculated from the posterior perfusion image of a ventilation perfusion scan. The PI was computed as the sum of differences versus control for the 9 deciles above background. Receiver operating characteristic curve analysis was used to compare PI with other parameters for predicting PAH.


RESULTS
Linear correlations of PI were found to be significant with the following parameters: pulmonary vascular resistance (r=0.81, P=0.00009), total pulmonary vascular resistance (MPAP/cardiac output) (r=0.80, P=0.00013), pulmonary artery systolic pressure (r=0.73, P=0.00018), MPAP (r=0.72, P=0.00022), pulmonary diastolic pressure (r=0.53, P=0.01), and right atrial pressure (r=0.50, P=0.03). Using logistic regression, the PI was significant in separating patients with PAH from controls (χ²=5.6, P=0.02).


CONCLUSIONS
The data suggest that PI can be used for the noninvasive diagnosis and measurement of severity of PAH.
Talwar
Arunabh
A
Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, North Shore University Hospital, New Hyde Park, NY 11040, USA. Arunabh@NSHS.EDU
Sarkar
Pralay
P
Patel
Nick
N
Shah
Rakesh
R
Babchyck
Barry
B
Palestro
Christopher J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002302:Cardiac Output; D015331:Cohort Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016284:Technetium Tc 99m Pentetate; D014463:Ultrasonography; D014655:Vascular Resistance
D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate