Published in:
01-12-2013 | Original Paper
Determination of cardiac output with dynamic contrast-enhanced computed tomography
Authors:
Michael Pienn, Gabor Kovacs, Maria Tscherner, Thorsten R. Johnson, Peter Kullnig, Rudolf Stollberger, Andrea Olschewski, Horst Olschewski, Zoltán Bálint
Published in:
The International Journal of Cardiovascular Imaging
|
Issue 8/2013
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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.