| Evaluation of pulmonary hypertension and surgical outcome by dynamic pulmonary perfusion imaging in patients with valvular disease. | |
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MedLine Citation:
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PMID: 21467847 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: : The gold standard for assessing the degree of pulmonary hypertension is by right ventricular catheterization, an invasive procedure. This study was carried out to evaluate a noninvasive method using dynamic pulmonary perfusion imaging (DPPI) for assessing pulmonary hypertension and surgical outcome in patients with valvular heart disease. METHODS: : A total of 116 patients (50 men, 66 women, mean age: 45.8 ± 10.7 years) with valvular disease and 10 healthy volunteers (4 men, 6 women; mean age: 40.2 ± 12.8 years) were included in this study. Baseline DPPI with Tc-99m macroaggregated albumin and right ventricular catheterization were performed in all patients, before mitral valve replacement with or without aortic valve replacement surgery, and healthy volunteers. At 7 to 14 days postsurgery, 105 patients were re-evaluated with DPPI. A total lung region of interest was used to calculate a time-activity curve from the DPPI. The lung equilibrium time (LET: time from Tc-99m macroaggregated albumin entering the lungs to equilibrium) was measured. Receiver operating characteristic analysis of LET for diagnosing pulmonary hypertension was carried out. RESULTS: : LET in patients with valvular heart disease was significantly prolonged compared with those in 10 healthy volunteers (P < 0.001). LET was 14.79 ± 4.37 seconds and 27.78 ± 10.26 seconds in 10 healthy volunteers and patients, respectively). A strong correlation between LET and mean pulmonary arterial pressure (r = 0.827, P < 0.001) was found. Using mean pulmonary arterial pressure as a gold standard and threshold value of LET at 22.7 seconds, the sensitivity and specificity of LET for assessing pulmonary hypertension were found to be 94.7% and 78.0%, respectively. The pre- and postsurgery LET were found to be significantly different (27.48 ± 9.83 seconds vs. 21.33 ± 6.18 seconds, P < 0.001). CONCLUSION: : DPPI is an accurate and noninvasive method for evaluating pulmonary hypertension and surgical outcome in patients with valvular heart disease. |
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Authors:
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Xuemei Wang; Rongfang Shi; Shiwei Pan; Wei Fang |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical nuclear medicine Volume: 36 ISSN: 1536-0229 ISO Abbreviation: Clin Nucl Med Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-06 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7611109 Medline TA: Clin Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 337-40 Citation Subset: IM |
Affiliation:
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From the *Department of Nuclear Medicine, Affiliated Hospital of Inner Mongolia Medical University, Huhehaote, China; and Departments of †Nuclear Medicine and ‡Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. |
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