[Positron emission tomography of regional extravascular lung water and regional pulmonary blood volume in chronic heart failure].

In 6 controls (group A), 4 patients with moderate congestive heart failure (NYHA II, II-III: group B) and 6 patients with severe heart failure (NYHA III, III-IV, IV: group C) regional lung water (rLW, constant infusion of H2 15O), regional pulmonary blood volume (rPBV, inhaled 11CO) and regional extravascular lung water (rELW = rLW -rPBV) were measured by positron emission tomography. The mean rELW was 0.12 +/- 0.02 g/cm3 in group A, 0.15 +/- 0.03 g/cm3 in group B and 0.19 +/- 0.06 g/cm3 in group C. In group C a significant increase in rELW was found from cranial to caudal regions (p less than 0.005), whereas in controls the distribution of rELW was almost homogeneous. The mean rPBV was 0.21 +/- 0.04 g/cm3 in group A, 0.22 +/- 0.04 g/cm3 in group B, and 0.17 +/- 0.03 g/cm3 in group C. There was a progressive increase in rPBV from cranial to caudal in group A. In group C the distribution of rPBV was almost uniform showing, compared to group A, significant lower values in the caudal regions (p less than 0.01). The study suggests that the amount and distribution of fluid in pulmonary congestion can be assessed noninvasively by positron emission tomography and that substantial differences in regional distribution exist between controls and patients with congestive heart failure.