Measurement of cardiac output from a test-bolus injection in multislice computed tomography

Mahnken, Andreas H.; Klotz, Ernst; Hennemuth, Anja; Jung, Bettina; Koos, Ralf; Wildberger, Joachim E.; Günther, Rolf W.

doi:10.1007/s00330-003-2054-x

Cited by 70 publications

(55 citation statements)

References 36 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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“…Reduction of SV, and, particularly, of the CO is associated with an increase in coronary artery opacification with 64-slice CT angiography. Knowledge of this effect can be helpful in developing optimal scanning strategies in patients with alterations of cardiac function, since the CO and SV could be noninvasively determined with a test bolus technique [26] immediately prior to coronary CT angiography. An adaptation of the contrast material regimen to the actual patient's hemodynamic condition, especially in cases of high CO, may be of potential benefit and thus deserves further evaluation.…”

Section: Discussionmentioning

confidence: 99%

Influence of cardiac hemodynamic parameters on coronary artery opacification with 64-slice computed tomography

et al. 2006

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Influence of cardiac hemodynamic parameters on coronary artery opacification with 64-slice computed tomographyAbstract The purpose of this study was to evaluate the influence of ejection fraction (EF), stroke volume (SV), heart rate, and cardiac output (CO) on coronary artery opacification with 64-slice computed tomography (CT). Sixty patients underwent, retrospectively, electrocardiography-gated 64-slice CT coronary angiography. Left ventricular EF, SV, and CO were calculated with semi-automated software. Attenuation values were measured and contrast-to-noise ratios (CNRs) were calculated in the proximal right coronary artery (RCA) and left main artery (LMA). Mean EF during scanning was 61.5±12.4%, SV was 63.2±15.6 ml, heart rate was 62.5±11.8 beats per minute (bpm), and CO was 3.88±1.06 l/min. There was no significant correlation between the EF and heart rate and the attenuation and CNR in either coronary artery. A significant negative correlation was found in both arteries between SV and attenuation (RCA r=−0.26, P<0.05; LMA r=−0.34, P<0.01) and between SV and CNR (RCA r=−0.26, P<0.05; LMA r=−0.26, P<0.05). Similarly, a significant negative correlation was found between the CO and attenuation (RCA r=−0.42, P<0.05; LMA r=−0.56, P<0.001) and between the CO and CNR (RCA r=−0.39, P<0.05; LMA r=−0.44, P<0.001). The actual hemodynamic status of the patient influences the coronary artery opacification with 64-slice CT, in that vessel opacification decreases as SV and CO increase.

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“…Un análisis posterior de las imágenes volumé-tricas obtenidas permitirá analizar distintos parámetros de interés clínico: anomalí-as en la contractilidad miocárdica, grosor miocárdico, fracción de eyección, volúme-nes cardiacos, etc 51,52 . Estudios recientes indican que existe una buena correlación entre los resultados de función cardiaca obtenidos mediante TCMC y otras técnicas diagnósticas como la ecocardiografía o la RM [53][54][55] (Fig.…”

Section: Valoración De La Función Cardiacaunclassified

TC multicorte (TCMC) cardiaca: aplicaciones clínicas

Bastarrika

Cano

Becker

et al. 2004

Anales Sis San Navarra

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RESUMENLa introducción de los equipos de TC multicorte y el desarrollo de técnicas de adquisición de imágenes con sincronización electrocardiográfica y reconstrucción retrospectiva han permitido que la TC multicorte cardiaca se pueda considerar hoy en día una técnica no invasiva muy útil para el estudio de la patología cardiaca en la práctica clínica diaria. La valoración de las arterias coronarias es una de las principales aplicaciones clínicas de esta técnica diagnóstica e incluye la detección y cuantificación del calcio coronario, la coronariografía por TC multicorte (estudio de la anatomía coronaria, variantes anatómicas y anomalías del origen y trayecto), la valoración angiográfica de la permeabilidad de injertos aortocoronarios y endoprótesis vasculares y la caracterización de las placas de ateroma. Los nuevos programas de reconstrucción y postprocesamiento permiten obtener, además, parámetros de morfología y contracción miocárdica y función cardiaca. Otras aplicaciones clínicas incluyen la caracterización de masas cardiacas intracavitarias y la valoración del pericardio.Palabras clave. Tomografía computarizada. Corazón. Anatomía. ABSTRACTSince the introduction of last generation multislice MSCT systems and the development of simultaneous electrocardiographic-tracing image acquisition and retrospective reconstruction techniques into clinical routine, cardiac MSCT has been considered a very useful non-invasive technique for the study of cardiac pathology in the daily clinical practice.One of the main clinical applications of this diagnostic technique is the evaluation of the coronary arteries including detection and quantification of coronary calcium, multislice CT coronary angiography (anatomy, anatomical variants and anomalies of the origin and course), the angiographic evaluation of the patency of aortocoronary by-pass grafts and coronary stents, and plaque characterization. The new reconstruction and postprocessing programs allow to obtain, in addition, parameters of myocardial morphology and contraction and cardiac function. Other clinical applications include the characterization of cardiac masses and the evaluation of the pericardium.

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Measurement of cardiac output from a test-bolus injection in multislice computed tomography

Cited by 70 publications

References 36 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

Influence of cardiac hemodynamic parameters on coronary artery opacification with 64-slice computed tomography

TC multicorte (TCMC) cardiaca: aplicaciones clínicas

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