Document Detail

Pulmonary oligemia in aortic valve disease.
MedLine Citation:
PMID:  9885584     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine whether the severity of the radiographic appearance of oligemia correlates with the severity of cardiac dysfunction. MATERIALS AND METHODS: Nine readers graded a set of 25 chest radiographs (15 cases of aortic valve disease [AVD], 10 control cases without AVD) for blood volume and ventricular size. Blood volume was graded on a scale of -3 (severe hyperemia) to 0 (normovolemia) to +3 (severe oligemia). Ventricular size was graded on a scale of 0 (normal) to 3 (massively enlarged). The oligemia and ventricular size grades were added to yield the radiographic severity index. Pulmonary capillary wedge pressure, pulmonary arterial pressure, stroke volume, and cardiac output were measured at the time of catheterization. RESULTS: The five more experienced readers achieved good nonchance agreement (kappa = 0.48; P < .001). They were unanimous in scoring 12 cases as oligemic; variations occurred only in severity assessments. Oligemia was due to emphysema in one case and to AVD in 11. In oligemic cases, radiographic severity correlated significantly with wedge pressure (r = 0.93, P < .001) and pulmonary arterial pressure (r = 0.93, P < .002). CONCLUSION: Many cases of AVD show oligemia. The severity of oligemia correlates well with hemodynamic abnormality. Oligemia may be caused by atrial-pulmonary-vascular reflex vasoconstriction, low right ventricular output, and possibly high levels of atrial natriuretic factor.
M A Bruno; E N Milne; W Stanford; C W Smith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  210     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-01-29     Completed Date:  1999-01-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  37-45     Citation Subset:  AIM; IM    
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232-2675, USA.
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MeSH Terms
Aortic Valve Insufficiency / physiopathology*,  radiography
Aortic Valve Stenosis / physiopathology*,  radiography
Blood Volume*
Heart Ventricles / radiography
Lung / radiography
Middle Aged
Observer Variation
Pulmonary Circulation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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