Elsevier

Journal of Nuclear Cardiology

Volume 15, Issue 2, March–April 2008, Pages 218-224
Journal of Nuclear Cardiology

Original article
Stroke volume measurements with first-pass dynamic positron emission tomography: Comparison with cardiovascular magnetic resonance

https://doi.org/10.1016/j.nuclcard.2007.11.016Get rights and content

Background

The assessment of forward stroke volume (SV) using dynamic, first-pass cardiac positron emission tomography (PET) was shown to be feasible in a limited number of studies with small numbers of subjects. The aim of this study was to compare first-pass derived SV with cardiovascular magnetic resonance imaging (CMR)-obtained values in a larger population of subjects.

Methods and Results

Fifty-nine subjects with varying degrees of cardiac function were studied. Stroke volume was assessed using oxygen-15-labeled water (H215O) dynamic first-pass PET for both the right ventricle (RV) and left ventricle (LV), and compared with the findings of aorta velocity-encoded phase-contrast CMR. The PET-estimated SV was higher for the RV than for the LV (133 ± 34 vs 116 ± 31 mL, P < .01, ± SD), and both were higher compared with values obtained by CMR (81 ± 20 mL, both P < .01, ± SD). Although significant, the correlations between PET and CMR were moderate for both the RV (r = 0.37, P < .01) and the LV (r = 0.40, P < .01, ± SD). Bland-Altman analysis revealed a progressive overestimation with increasing SV measured in either ventricle.

Conclusions

First-pass dynamic H215O PET for the assessment of forward SV is feasible, although values are progressively overestimated with increasing SV, particularly when the RV is used, and correlations with aorta velocity-encoded phase-contrast CMR are moderate. These findings are probably protocol-dependent and warrant further study before the use of first-pass dynamic H215O PET in clinical or research settings can be advocated.

Section snippets

Study Population

Subjects included in this study were recruited consecutively from various study protocols investigating myocardial perfusion, for which they underwent both dynamic H215O PET and CMR. The study population consisted of 59 subjects: 38 healthy volunteers or patients with diabetes without systolic LV dysfunction (mean age, 54 ± 8 years, ± SD), 6 patients with idiopathic dilated cardiomyopathy (DCM; mean age, 60 ± 9 years, ± SD), and 15 patients with hypertrophic cardiomyopathy (HCM; mean age, 57 ±

Hemodynamics and LV Dimensions

Mean heart rate (63 ± 11 vs 65 ± 10 beats · min−1, P = NS) and mean arterial pressure (88 ± 9 vs 89 ± 16 mmHg, P = NS) were similar during the PET and CMR studies. The CMR-derived mean LVEDV and LVESV were 182 ± 55 mL and 83 ± 59 mL, respectively, yielding a mean LVEF of 57 ± 14% (range, 9%-74%).

CO and Forward SV Measurements

Table 1 lists the PET and CMR estimated forward CO and forward SV measurements. The CMR estimated forward SV ranged from 34 to 164 mL (mean, 81 ± 20 mL). The CMR-obtained forward SV was significantly

Discussion

The present study was conducted to validate the previously reported use of first-pass dynamic PET using H215O in estimating forward SV in a large group of subjects with a wide range of cardiac function. The results suggest that, when taking aorta velocity-encoded phase-contrast CMR as a reference, this approach results in an overestimation of SV. Furthermore, although significant, the correlation between techniques is moderate at best. In addition, the extent of overestimation is related to

References (18)

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