Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery

Nakahara, Takehiro; Yamada, Minoru; Yokoyama, Yoichi; Yamada, Yoshitake; Narita, Kentaro; Imanishi, Nobuaki; Yamazaki, Masataka; Shimizu, Hideyuki; Narula, Jagat; Jinzaki, Masahiro

doi:10.1038/s41598-021-90998-7

Cited by 2 publications

(2 citation statements)

References 34 publications

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“…All patients underwent both upright chest low-radiation-dose CT in the standing position, with arms down, using a 320-detectorrow upright CT (prototype TSX-401R, Canon Medical Systems; Fig. 1A) [1][2][3][14][15][16][17], and conventional chest low-radiationdose CT in the supine position, with arms raised, using a 320detector-row CT (Aquilion ONE, Canon Medical Systems). These two examinations were performed consecutively within 2 hours; both scans were unenhanced and were performed during deep inspiration breath-hold, with automatic exposure control using a noise index of 24 for a 5-mm slice thickness (tube current range, 10-350 mA).…”

Section: Ct Imaging Protocolmentioning

confidence: 99%

Estimating right atrial pressure using upright computed tomography in patients with heart failure

et al. 2022

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Objectives Upright computed tomography (CT) can detect slight changes particularly in the superior vena cava (SVC) volume in healthy volunteers under the influence of gravity. This study aimed to evaluate whether upright CT-based measurements of the SVC area are useful for assessing mean right atrial pressure (mRAP) in patients with heart failure. Methods We performed CT in both standing and supine positions to evaluate the SVC (directly below the junction of the bilateral brachiocephalic veins) and inferior vena cava (IVC; at the height of the diaphragm) areas and analyzed their relationship with mRAP, measured by right heart catheterization in 23 patients with heart failure. Results The median age of enrolled patients was 60 (51−72) years, and 69.6% were male. The median mRAP was 3 (1−7) mmHg. The correlations between the standing position SVC and IVC areas and mRAP were stronger than those in the supine position (SVC, ρ = 0.68, p < 0.001 and ρ = 0.43, p = 0.040; IVC, ρ = 0.57, p = 0.005 and ρ = 0.46, p = 0.026; respectively). Furthermore, the SVC area in the standing position was most accurate in identifying patients with higher mRAP (> 5 mmHg) (SVC standing, area under the receiver operating characteristic curve [AUC] = 0.91, 95% confidence interval [CI], 0.77–1.00; SVC supine, AUC = 0.78, 95% CI, 0.59–0.98; IVC standing, AUC = 0.77, 95% CI, 0.55–0.98; IVC supine, AUC = 0.72, 95% CI, 0.49–0.94). The inter- and intraobserver agreements (evaluated by intraclass correlation coefficients) for all CT measurements were 0.962–0.991. Conclusions Upright CT-based measurement of the SVC area can be useful for non-invasive estimation of mRAP under the influence of gravity in patients with heart failure. Key Points • This study showed that the superior vena cava (SVC) area in the standing position was most accurate in identifying patients with heart failure with higher mean right atrial pressure. • Upright computed tomography-based measurements of the SVC area can be a promising non-invasive method for estimating mean right atrial pressure under the influence of gravity in patients with heart failure. • Clinical management of patients with heart failure based on this non-invasive modality may lead to early assessment of conditional changes and reduced hospitalization for exacerbation of heart failure.

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Section: Ct Imaging Protocolmentioning

confidence: 99%

Estimating right atrial pressure using upright computed tomography in patients with heart failure

et al. 2022

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“…We developed an upright CT that reveals the posture of organs in the upright position 10 , and determined the effect of gravity on human anatomy employing volunteers 11 – 14 .…”

Section: Introductionmentioning

confidence: 99%

Anatomical cardiac and electrocardiographic axes correlate in both upright and supine positions: an upright/supine CT study

Norimatsu,

Nakahara,

Yamada

et al. 2023

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The correlation between the anatomical cardiac and electrocardiographic axes has been discussed for several years. Using upright computed tomography, this study aimed to reveal the relationship between the anatomical cardiac and electrocardiographic axes in both the supine and upright positions. Upright CT and standard supine CT were performed for healthy volunteers, following electrocardiography in both upright and supine position. On CT images, the coordinates of apex, the center of aortic valve (AV) and mitral valve (MV) were recorded, and the vectors and angles were calculated. Subcutaneous and visceral fat volume were semi-automatically calculated in a workstation. From a total 190 volunteers, 41 males were performed electrocardiography and included for this study. The QRS and anatomical axes (AV-apex and MV-apex axis) were significantly correlated in both supine and upright positions, while the angle of the AV-apex to Z axis was the most correlated (supine: r = − 0.54, p = 0.0002, upright: r = − 0.47, p = 0.0020). The anatomical axis moved in the dorsal and caudal directions from the supine to upright position. Multiple regression analysis revealed that the anatomical axis from the AV-apex to the Z-axis was determined according to age, body height, subcutaneous and visceral fat volumes.

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Saphenous vein valve assessment utilizing upright CT to potentially improve graft assessment for bypass surgery

Cited by 2 publications

References 34 publications

Estimating right atrial pressure using upright computed tomography in patients with heart failure

Estimating right atrial pressure using upright computed tomography in patients with heart failure

Anatomical cardiac and electrocardiographic axes correlate in both upright and supine positions: an upright/supine CT study

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