Abstract 12312: Right Ventricular End Diastolic and Systolic Volume Measurements on ECG-Gated 320 Slice CT Could Predict Occurrence of Adverse Events in Subjects With Pulmonary Hypertension. A Study With a Median of 18 Months Follow-Up
Purpose: To predict occurrence of adverse events (AE) in subjects with pulmonary hypertension (PH), we quantitative measured three dimensional right ventricular (RV) end-diastolic (RVEDV) and end-systolic volume (RVESV) in PH subjects using ECG-gated enhanced 320 slice CT.
Materials and Methods: 56 PH subjects (15 males, 57 ± 15 years, 33 chronic thromboembolic PH, 21 pulmonary arterial (PA) hypertension and 2 others) underwent retrospective ECG-gated 320 slice CT (Aquilion one). To obtain not only images of the whole heart including RV and coronary arteries, but also images of the PA, all CT scans were obtained using a double volume conventional scan with retrospective ECG-gating with a 0.5 mm slice thickness and tube current dose modulation. We injected 60 ml of contrast material (350 mgI/ml) at 3.5 ml/s, followed by injection of a saline-to-contrast material mixture (40 ml contrast material at 2.0 ml/s and 30 ml saline at 1.5 ml/s), followed by injection of 20 ml pure saline at 1.5 ml/s. CT images were reconstructed every 5% from 0-95% of ECG R-to-R interval and RV end diastolic and end systolic images were obtained. Subjects were followed for a median of 18 months.
Results: AE occurred in 11 subjects (5 males, 60 ± 10 years); Cardiac death (3), heart failure (6), cerebral hemorrhage (2). Receiver operating characteristic (ROC) curves of RVEDV and RVESV on CT showed area under the curve (AUC) of 0.646 and 0.590, respectively, and best cutoff points of 125.2 cm3 (sensitivity 72.7%, specificity 60%) and 113.5 cm3 (sensitivity 54.5%, specificity 80%), respectively, to distinguish subjects with and without AEs. By Kaplan Meier analysis, there was significant differences in incidence of AEs between ≥ and ≤ 125.2 cm3 of RVEDV on CT (P = 0.050). In a similar analysis, there was significant differences in incidence of AEs between ≥ and ≤ 113.5 cm3 of RVESV on CT (P=0.031).
Conclusion: RVEDV and RVESV measurements on ECG gated 320 slice CT could predict short term poor prognosis in PH subjects.
- © 2013 by American Heart Association, Inc.