title: Determination of cardiac output with dynamic contrast-enhanced computed tomography.
abstract: Cardiac output (CO) is an important diagnostic and prognostic factor in the haemodynamic evaluation of patients. The gold standard for CO measurement, thermodilution, requires an invasive right-heart catheterisation (RHC). In this pilot study we aimed to determine the accuracy of non-invasive CO determination from dynamic contrast-enhanced computed tomography (CT) compared to thermodilution. Patients who underwent diagnostic or follow-up RHC due to suspected or known pulmonary vascular disease at our department and required a thoracic CT between June 2011 and August 2012 were included. CO was determined from CT attenuation-time curves in the pulmonary artery and the ascending aorta using a dynamic contrast-enhanced CT sequence. CO determined in N = 18 patients by dynamic CT in the pulmonary artery was in very good agreement with thermodilution data (r = 0.84). Bland-Altman analysis showed a systematic overestimation of 0.7 ± 0.6 l/min compared to thermodilution. Data from the ascending aorta also showed a good correlation, but with a larger scattering of the values. The average effective dose for the dynamic investigation was 1.2 ± 0.7 mSv. CO determined with dynamic contrast-enhanced CT in the main pulmonary artery reliably predicts the values obtained by thermodilution during RHC. This non-invasive technique might provide an alternative for repeated invasive right-heart catheter investigations in the follow-up of pulmonary arterial hypertension patients.
authors: Ludwig Boltzmann Institute for Lung Vascular Research, Stiftingtalstrasse 24, 8010, Graz, Austria.
authors: Michael
authors: M
authors: Pienn
authors: Gabor
authors: G
authors: Kovacs
authors: Maria
authors: M
authors: Tscherner
authors: Thorsten R
authors: TR
authors: Johnson
authors: Peter
authors: P
authors: Kullnig
authors: Rudolf
authors: R
authors: Stollberger
authors: Andrea
authors: A
authors: Olschewski
authors: Horst
authors: H
authors: Olschewski
authors: Zoltán
authors: Z
authors: Bálint
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology; D001027:Aortography; D006328:Cardiac Catheterization; D002302:Cardiac Output; D003287:Contrast Media; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007472:Iohexol / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D013815:Thermodilution; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
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