Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Eur J Radiol. 2023 Apr;161:110729. doi: 10.1016/j.ejrad.2023.110729. Epub 2023 Feb 4.
Dynamic chest radiography allows for non-invasive cardiopulmonary blood flow assessment. However, data on its use for heart failure hemodynamic assessment are scarce. We utilized dynamic chest radiography to estimate heart failure hemodynamics.
Twenty heart failure patients (median age, 67 years; 17 men) underwent dynamic chest radiography and right heart catheterization. The analyzed images were 16-bit images (grayscale range: 0-65,535). Right atrial, right pulmonary artery, and left ventricular apex pixel values (average of the grayscale values of all pixels within a region of interest) were measured. The correlations of the minimum, maximum, mean, amount of change, and rate of change in pixel values with right atrial pressure, pulmonary artery pressure, pulmonary artery wedge pressure, and cardiac index were analyzed.
The mean right atrial pixel value and mean right atrial pressure (R = -0.576, P = 0.008), mean right pulmonary artery pixel value and mean pulmonary artery pressure (R = -0.546, P = 0.013), and left ventricular apex pixel value change rate and mean pulmonary artery wedge pressure (R = -0.664, P = 0.001) or cardiac index (R = 0.606, P = 0.005) were correlated. The left ventricular apex pixel value change rate identified low cardiac index (area under the curve, 0.792; 95% confidence interval, 0.590-0.993; P = 0.031) and low cardiac index with high pulmonary artery wedge pressure (area under the curve, 0.902; 95% confidence interval, 0.000-1.000; P = 0.030).
Dynamic chest radiography is a minimally invasive tool for heart failure hemodynamic assessment.
动态胸部 X 线摄影可用于非侵入性心肺血流评估。然而，关于其在心力衰竭血液动力学评估中的应用的数据却很少。我们利用动态胸部 X 线摄影来评估心力衰竭的血液动力学。
20 例心力衰竭患者（中位年龄 67 岁；17 名男性）接受了动态胸部 X 线摄影和右心导管检查。所分析的图像为 16 位图像（灰度范围：0-65535）。测量右心房、右肺动脉和左心室心尖的像素值（感兴趣区域内所有像素的灰度值平均值）。分析像素值的最小值、最大值、平均值、变化量和变化率与右心房压、肺动脉压、肺动脉楔压和心指数的相关性。
平均右心房像素值与平均右心房压（R=-0.576，P=0.008）、平均右肺动脉像素值与平均肺动脉压（R=-0.546，P=0.013）、左心室心尖像素值变化率与平均肺动脉楔压（R=-0.664，P=0.001）或心指数（R=-0.606，P=0.005）呈负相关。左心室心尖像素值变化率可识别低心指数（曲线下面积，0.792；95%置信区间，0.590-0.993；P=0.031）和低心指数伴高肺动脉楔压（曲线下面积，0.902；95%置信区间，0.000-1.000；P=0.030）。
动态胸部 X 线摄影是一种用于心力衰竭血液动力学评估的微创工具。
