Abstract 12727: Prediction of Occurrence of Adverse Events Using Right Ventricular End Diastolic and Systolic Volume Measurements on ECG-Gated 320 Slice CT in Subjects With Chronic Thromboembolic Pulmonary Hypertension. A Study With a Median of 23 Months Follow-Up
Introduction: Right ventricular (RV) volume measurements may predict short term prognosis in subjects with chronic pulmonary thromboembolic pulmonary hypertension (CTEPH).
Aim: To predict occurrence of adverse events (AE) in subjects with CTEPH, we quantitative measured three dimensional RV end-diastolic (RVEDV) and end-systolic volume (RVESV) in these subjects using ECG gated enhanced 320 slice CT.
Methods: 29 CTEPH subjects (9 males, 58 ± 15 years) underwent retrospective ECG gated 320 slice CT (Aquilion one, Toshiba Medical). To obtain not only images of the whole heart including RV and coronary arteries, but also images of the pulmonary artery, 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 and RVEDV and RVESV were measured. Subjects were followed for a median of 23 months. AE included cardiac death and hospitalization due to heart failure.
Results: AE occurred in 3 subjects (2 males, 65 ± 8 years); all were hospitalization due to heart failure. Receiver operating characteristic curves of RVEDV and RVESV on CT showed area under the curve of 0.923 and 0.923, respectively, and best cutoff points of 210.3 cm3 (sensitivity 100%, specificity 92.3%) and 152.6 cm3 (sensitivity 100%, specificity 92.3%), respectively, to distinguish subjects with and without AEs. By Kaplan Meier analysis, there was significant differences in incidence of AEs between ≥ and < 210.3 cm3 of RVEDV on CT (P<0.001). In a similar analysis, there was significant differences in incidence of AEs between ≥ and < 152.6 cm3 of RVESV on CT (P<0.001).
Conclusion: RVEDV and RVESV measurements on ECG gated 320 slice CT could predict short term poor prognosis in CTEPH subjects. ECG gated 320 slice can provide useful information about RV volume as well as pulmonary arteries and coronary arteries.
Author Disclosures: K. Ozawa: None. N. Funabashi: None. H. Takaoka: None. N. Tanabe: None. K. Tatsumi: None. Y. Kobayashi: None.
- © 2014 by American Heart Association, Inc.