Schmermund A, Rensing B J, Sheedy P F, Rumberger J A
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.
Int J Card Imaging. 1998 Jun;14(3):201-9. doi: 10.1023/a:1006047613019.
The applicability and reproducibility of electron-beam computed tomography (EBCT) was tested to define left and right ventricular volumes in patients with congestive heart failure in a clinical setting.
Ten patients (mean age 64 +/- 11 years) with dilated hearts and stable congestive heart failure (functional class III-IV) were studied. After determination of the individual circulation time, two serial short axis polytomographic EBCT studies were performed within a mean interval of 14.8 +/- 10 days. Following intravenous contrast administration, biventricular end-diastolic volumes (LVEDV, RVEDV), end-systolic volumes (LVESV, RVESV), and left ventricular muscle mass (LVMM) were determined using previously developed techniques.
Adequate contrast opacification in both ventricular cavities was obtained in all patients at baseline and at follow-up. Values were 323.4 +/- 99.3 (mean +/- SD) and 332.6 +/- 105.4 ml for LVEDV, 249.3 +/- 75.6 and 250.5 +/- 79.3 ml for LVESV, 236.8 +/- 56.2 and 251.2 +/- 72.7 ml for RVEDV, 179.8 +/- 76.4 and 188.3 +/- 64.0 ml for RVESV, and 207.7 +/- 70.6 and 204.9 +/- 81.9 g for LVMM (p = NS, respectively, paired t-test). Linear regression analysis correlating biventricular volumes and left ventricular muscle mass measurements in the serial scans yielded r-values in the range of 0.89 to 0.95 and a small SEE. The SE of the mean differences between left and right ventricular ejection fraction measurements was 1 point, respectively.
EBCT studies of ventricular volumes in patients with dilated hearts and congestive heart failure are highly reproducible and offer the potential for serial assessment of these patients in whom quantitation of ventricular volumes has been shown to be of prognostic value.
在临床环境中,对电子束计算机断层扫描(EBCT)在定义充血性心力衰竭患者左、右心室容积方面的适用性和可重复性进行了测试。
对10例(平均年龄64±11岁)心脏扩大且充血性心力衰竭稳定(心功能Ⅲ - Ⅳ级)的患者进行研究。在确定个体循环时间后,平均间隔14.8±10天进行了两次连续的短轴断层EBCT研究。静脉注射造影剂后,使用先前开发的技术测定双心室舒张末期容积(LVEDV、RVEDV)、收缩末期容积(LVESV、RVESV)和左心室肌肉质量(LVMM)。
所有患者在基线和随访时,两个心室腔内均获得了足够的造影剂充盈。LVEDV值分别为323.4±99.3(平均值±标准差)和332.6±105.4 ml,LVESV值分别为249.3±75.6和250.5±79.3 ml,RVEDV值分别为236.8±56.2和251.2±72.7 ml,RVESV值分别为179.8±76.4和188.3±64.0 ml,LVMM值分别为207.7±70.6和204.9±81.9 g(配对t检验,p =无显著性差异)。系列扫描中双心室容积与左心室肌肉质量测量值的线性回归分析得出r值在0.89至0.95范围内,且标准误较小。左、右心室射血分数测量值之间平均差异的标准误分别为1分。
对心脏扩大和充血性心力衰竭患者进行心室容积的EBCT研究具有高度可重复性,并为对这些患者进行系列评估提供了可能,在这些患者中,心室容积的定量已被证明具有预后价值。