Noninvasive method to assess cor pulmonale in patients with chronic obstructive pulmonary disease.

In our study of 15 patients with chronic obstructive pulmonary disease, we performed myocardial perfusion single-photon-emission computerized tomography (SPECT) with thallium-201 to quantitatively assess right ventricular hypertrophy. On the SPECT images, we determined the ratio of activity in the right-to-left ventricular wall as the thallium score. Right ventricular ejection fraction (RVEF) was measured by multigated equilibrium radionuclide ventriculography with krypton-81m. Both the thallium scores and RVEF values correlated well with pulmonary arterial pressure (r = 0.65 and r = -0.86, respectively) and permitted the structural and functional assessment of cor pulmonale. When the patients were classified according to the thallium scores and RVEF values, those who had both a high thallium score and reduced RVEF had a significantly high pulmonary arterial pressure and vice versa. The combined evaluation of the thallium score and RVEF enabled accurate noninvasive assessment of cor pulmonale.