Measurement of cardiac output by cine computed tomography

Garrett, Jeffrey S.; Lanzer, Peter; Jaschke, Werner; Botvinick, Elias H.; Sievers, Richard E.; Higgins, Charles B.; Lipton, Martin J.

doi:10.1016/0002-9149(85)91030-6

Cited by 48 publications

(24 citation statements)

References 9 publications

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“…After a minimum of four weeks to minimize recall bias, the PARCA measurements were repeated by the original reader for intra-ob server variability assessment and by a second blinded independent reader for inter-observer variability. Correlation was similarly assessed to compare the Stewart-Hamilton-based CO with the echo-based CO. Based on previous studies by Garrett et al and Mahnken et al [6,8], time-enhancement curves were calculated for determination of CO from the test-bolus data via a similar ROI analysis as described above. The time-enhancement curves were transferred to a separate computer equipped with a dedicated software tool for the calculation of CO based on the Stewart Hamilton equation:…”

Section: Discussionmentioning

confidence: 99%

“…Such methodology has been replicated determining a contrast-based time-enhancement curve by gamma variate to exclude recirculation and cardiac output determination by the Stewart-Hamilton equation [6][7][8], but a simpler calculation that does not require dedicated software tools would be advantageous for adoption. Analogous to this method, we hypothesized that CO may be inversely to peak aortic root contrast attenuation (PARCA) as faster contrast washout from the aortic root during timing bolus scanning may occur with higher output, as suggested by preclinical study [9].…”

Section: Introductionmentioning

confidence: 99%

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Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Angiography

Mehta¹,

Choi²,

Sanai³

et al. 2012

ACT

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Background: Cardiac output can be estimated during retrospectively gated CT coronary angiography by anatomically determining left ventricular volumes; prospective triggering to minimize radiation precludes this methodology. We propose an alternative method for cardiac output estimation based on preclinical models suggesting that cardiac output may be inversely related to contrast washout from the aortic root during timing bolus scanning, as measured by peak aortic root contrast attenuation. Methods: 34 patients had CT coronary angiography timing bolus performed with 20 ml iodixanol at 5.5 ml/s followed by 20 ml normal saline at 5.5 ml/s through an 18-Ga antecubital catheter. Peak aortic root contrast attenuation was correlated to cardiac output calculated by echocardiography using heart rate stroke volume from biplane Simpson's method. Results: Mean age was 58 ± 13 years; body surface area, 2.0 ± 0.5 m 2 . 53% were women. Stroke volume, cardiac output and cardiac index were 67 ± 19 ml, 4.5 ± 1.6 L/min, and 2.2 ± 0.7 L/min/m 2 , respectively. Peak aortic root contrast attenuation was 207 ± 46 HU and correlated to cardiac output and cardiac index with r = -0.64, p < 0.0001 and r = -0.55, p < 0.001, respectively. Regression analysis estimates cardiac output = -0.02 peak aortic root contrast attenuation +9.1. Conclusion: This novel method for cardiac output estimation by CTCA appears feasible. The CT physiologic parameters using the timing test-bolus data moderately correlated with echocardiographic assessment of cardiac output. The calculation of cardiac output adds important hemodynamic data to anatomic information provided by CTCA, and further development of this method may preserve assessment of left ventricular performance in prospective triggering.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Angiography

Mehta¹,

Choi²,

Sanai³

et al. 2012

ACT

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“…O método se baseia na detecção da curva de concentração de um marcador em um ponto distante do local de injeção. O contraste iodado pode ser utilizado como marcador, e as medidas de densidade da tomografia apresentam relação linear com a concentração de contraste no sangue (13,14).…”

Section: Introductionunclassified

“…Desta forma, uma aquisição dinâmica no nível dos grandes vasos permite a medida seriada da concentração de contraste, com posterior estimativa do débito cardíaco por meio da equação de Stewart-Hamilton (13). Conceitualmente, a técnica é semelhante à medida do débito cardíaco pelo método de termodiluição de Fick (13 Além de estar relacionada diretamente ao débito cardíaco, a avaliação dos tempos para a chegada do meio de contraste até a veia cava superior e da cava superior até a artéria pulmonar pode, potencialmente, estar relacionada a alterações na resistência da circulação pulmonar e vem sendo ativamente estudada em pacientes com hipertensão pulmonar (23)(24)(25).…”

Section: Introductionunclassified

“…Conceitualmente, a técnica é semelhante à medida do débito cardíaco pelo método de termodiluição de Fick (13 Além de estar relacionada diretamente ao débito cardíaco, a avaliação dos tempos para a chegada do meio de contraste até a veia cava superior e da cava superior até a artéria pulmonar pode, potencialmente, estar relacionada a alterações na resistência da circulação pulmonar e vem sendo ativamente estudada em pacientes com hipertensão pulmonar (23)(24)(25). Em estudo com pacientes com hipertensão arterial pulmonar, Skrok et al (27) demonstraram diferença significativa entre os tempos circulação entre o ventrículo direito e o ventrículo esquerdo nos pacientes com hipertensão arterial pulmonar…”

Section: Introductionunclassified

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Avaliação da dinâmica normal da circulação do meio de contraste em estruturas vasculares nos exames de tomografia computadorizada das artérias coronárias

Morato¹

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Introduction: The use of contrast agents is a common radiological practice in chest tomography (CT) examinations. It's known that the transit time of the contrast agent (TTC) between the injection site and the systemic circulation is related to the cardiac output and can add important functional information. Nevertheless, there is little information regarding the normal transit times.Objectives: Measure the TTC between main pulmonary artery and ascending aorta in coronary artery CT's of healthy patients, defining the normality values for such circulatory times.Methods: Healthy ambulatorial patients who underwent coronary artery CT were included. The TTC's between the injection site and inferior vena cava, main pulmonary artery and ascending aorta were measured using the bolus tracking images. The cardiac output was measured from the CT images using the geometric method.Results: 18 patients were included in the analysis. The mean TTC between the mean pulmonary artery and aorta was 6,8 ± 1,6s. There was no significant correlation between the TTC and cardiac output measured by the geometric method.Conclusion: The normal value for the TTC between main pulmonary artery and ascending aorta was determined, and can be used as a reference for future publications.

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Systolic and diastolic performance in normal human subjects as measured by ultrafast computed tomography

Wachspress

Clark

Untereker

et al. 1988

Cathet. Cardiovasc. Diagn.

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Ultrafast computed tomography (ultrafast-CT) is a minimally invasive imaging modality with very short acquisition time and excellent anatomic definition. It shows promise of providing precise measurement of right and left ventricular volumes, left ventricular mass, and left ventricular diastolic function with a single test. We expand on the knowledge regarding normal humans by studying ten normal volunteers in the short axis. Cardiac volumes and mass (mean +/- 1 S.D.) were as follows: 1) left ventricle: end-diastolic volume index (ml/m2) = 61 +/- 15, end-systolic volume index (ml/m2) = 19 +/- 7, stroke volume index (ml/m2) = 43 +/- 9, cardiac index (liters/min/m2) = 2.7 +/- .5, ejection fraction (%) = 70 +/- 7, end-diastolic mass (g/m2) = 95 +/- 15; 2) right ventricle: end-diastolic volume index (ml/m2) = 76 +/- 19, end-systolic volume index (ml/m2) = 35 +/- 13, stroke volume index (ml/m2) = 40 +/- 8, cardiac index (liters/min/m2) = 2.6 +/- .5, ejection fraction (%) = 55 +/- 6. Stroke volume index differed by 1.6 +/- 2.0 ml/m2 between ventricles. Measurement of global and segmental left ventricular diastolic function revealed: 1) Peak filling rate (end-diastolic volumes/second): global = 2.29 +/- .40, base = 1.78 +/- .49, midventricle = 2.49 +/- .57, apex = 3.13 +/- .39 (P less than .001, base vs. apex; P less than .01, base vs. midventricle and midventricle vs. apex); 2) time to peak filling rate (msec): global = 193 +/- 24, base = 192 +/- 20, midventricle = 194 +/- 26, apex = 190 +/- 19 (P = NS between levels).(ABSTRACT TRUNCATED AT 250 WORDS)

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Measurement of cardiac output by cine computed tomography

Cited by 48 publications

References 9 publications

Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Angiography

Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Angiography

Avaliação da dinâmica normal da circulação do meio de contraste em estruturas vasculares nos exames de tomografia computadorizada das artérias coronárias

Systolic and diastolic performance in normal human subjects as measured by ultrafast computed tomography

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