Determination of cardiac output with dynamic contrast-enhanced computed tomography

Michael Pienn, Gabor Kovacs, Maria Tscherner, Thorsten R Johnson, Peter Kullnig, Rudolf Stollberger, Andrea Olschewski, Horst Olschewski, Zoltán Bálint

Research output: Contribution to journalArticleResearchpeer-review

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.

Original languageEnglish
Pages (from-to)1871-8
Number of pages8
JournalThe International Journal of Cardiovascular Imaging
Volume29
Issue number8
DOIs
Publication statusPublished - Dec 2013

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Thermodilution
Cardiac Output
Tomography
Cardiac Catheterization
Pulmonary Artery
Aorta
Cardiac Catheters
Vascular Diseases
Pulmonary Hypertension
Lung Diseases
Thorax
Hemodynamics

Keywords

  • Adult
  • Aged
  • Aorta
  • Aortography
  • Cardiac Catheterization
  • Cardiac Output
  • Contrast Media
  • Familial Primary Pulmonary Hypertension
  • Female
  • Humans
  • Hypertension, Pulmonary
  • Iohexol
  • Male
  • Middle Aged
  • Pilot Projects
  • Predictive Value of Tests
  • Pulmonary Artery
  • Radiation Dosage
  • Radiographic Image Interpretation, Computer-Assisted
  • Reproducibility of Results
  • Thermodilution
  • Time Factors
  • Tomography, X-Ray Computed
  • Comparative Study
  • Evaluation Studies
  • Journal Article

Cite this

Determination of cardiac output with dynamic contrast-enhanced computed tomography. / Pienn, Michael; Kovacs, Gabor; Tscherner, Maria; Johnson, Thorsten R; Kullnig, Peter; Stollberger, Rudolf; Olschewski, Andrea; Olschewski, Horst; Bálint, Zoltán.

In: The International Journal of Cardiovascular Imaging, Vol. 29, No. 8, 12.2013, p. 1871-8.

Research output: Contribution to journalArticleResearchpeer-review

Pienn, M, Kovacs, G, Tscherner, M, Johnson, TR, Kullnig, P, Stollberger, R, Olschewski, A, Olschewski, H & Bálint, Z 2013, 'Determination of cardiac output with dynamic contrast-enhanced computed tomography' The International Journal of Cardiovascular Imaging, vol. 29, no. 8, pp. 1871-8. https://doi.org/10.1007/s10554-013-0279-6
Pienn, Michael ; Kovacs, Gabor ; Tscherner, Maria ; Johnson, Thorsten R ; Kullnig, Peter ; Stollberger, Rudolf ; Olschewski, Andrea ; Olschewski, Horst ; Bálint, Zoltán. / Determination of cardiac output with dynamic contrast-enhanced computed tomography. In: The International Journal of Cardiovascular Imaging. 2013 ; Vol. 29, No. 8. pp. 1871-8.
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