12 Jan

Prediction of Pulmonary Arterial Pressure in Chronic Obstructive Pulmonary Disease by Radionuclide Ventriculography: Results

Prediction of Pulmonary Arterial Pressure in Chronic Obstructive Pulmonary Disease by Radionuclide Ventriculography: ResultsStudy Protocol
In group 1, Kr RVEF was measured at rest and correlated to the pulmonary hemodynamic measurements performed during the same week.
In group 2, “”Tc RVEF and the other noninvasive parameters were correlated to pulmonary arterial pressures and resistances measured simultaneously.
Statistics
These consisted of linear, logarithmic and exponential correlations between noninvasive parameters and pulmonary hemodynamics.
Results
The plotting of 81mKr RVEF and mean pulmonary arterial pressure, presented in Figure 2, shows that both parameters are correlated (r= — 0.75) though not perfectly.

Correlations between curve parameters derived from the ECG-gated right volume curve and mean pulmonary arterial pressure are presented in Table 2. None of these curve parameters correlates better with mean pulmonary arterial pressure than RVEF even when using a logarithmic or exponential correlation instead of a linear correlation. Figures 3 and 4 show the calculated parameters of the systolic and diastolic phases which correlate best with mean pulmonary arterial pressure, respectively first third ejection and filing rate.
The same results have been observed with the systolic pulmonary arterial pressure and the pulmonary vascular resistance index (Table 2).
Discussion
In chronic obstructive pulmonary disease, pulmonary arterial hypertension frequently induces cor pulmonale and symptomatic right congestive heart failure with poor prognosis. The higher the pulmonary arterial pressure, the worse the prognosis. Therefore, the determination of this parameter seems interesting for both the evaluation and the follow-up of COPD patients. Since measuring pulmonary arterial pressure requires right heart catheterization, a traumatic and expensive procedure, a variety of other techniques have been proposed, including chest roentgenography, echocardiography, radionuclide angiography and others. Unfortunately, up to now, none of them has yielded accurate estimations of pulmonary arterial pressure.

Figure 2. Linear correlation between *”Kr right ventricular ejection fraction and mean pulmonary arterial pressure in 16 patients with COPD.

Figure 2. Linear correlation between *”Kr right ventricular ejection fraction and mean pulmonary arterial pressure in 16 patients with COPD.

Figure 3. Linear correlation between first third ejection rate and mean pulmonary arterial pressure in 41 patients with COPD.

Figure 3. Linear correlation between first third ejection rate and mean pulmonary arterial pressure in 41 patients with COPD.

Figure 4. Linear correlation between first third filling rate and mean pulmonary arterial pressure in 41 patients with COPD.

Figure 4. Linear correlation between first third filling rate and mean pulmonary arterial pressure in 41 patients with COPD.

Table 2—Linear Correlation Between Radionuclide and Hemodynamic Barometers.

PAP PAPS PVRI
Systolic phase
Pre-ejection period ms + 0.10 +0.05 +0.14
Time to peak ejection rate ms +0.24* +0.26* +0.30*
Time to first third systole ms +0.24* +0.23* +0.28*
Total ejection time ms + 0.04 +0.09 +0.14
First third ejection rate count-s ~ -0.494: -0.52* -0.38*
Peak ejection rate count’s -0.29* -0.35* -0.28*
Mean ejection rate count’s -0.43* -0.46* -0.41*
First third/total ejection rate count’s + 0.17 +0.10 +0.13
TPER-PEP§ ms +0.14 +0.19 +0.15
Diastolic phase
Rapid filling time ms -0.06 -0.04 -0.07
Slow filling time ms -0.25* -0.23* -0.20*
Time to peak filling rate ms +0.01 +0.01 -0.01
Time to first third diastole ms +0.02 +0.06 +0.05
Total filling time ms -0.26* -0.24* -0.22*
Peak filling rate count’s -0.13 -0.19 -0.15
First third filling rate count’s —0.34* -0.35* -0.29*
Mean filling rate count’s -0.23* -0.27* -0.22*
First third to total filling rate -0.15 -0.19 -0.22*
KV ejection fraction % -0.61* -0.63* -0.54*

© 2019 - Men’s Health Info Blog