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Diagnosing and grad...
Diagnosing and grading heart failure with tomographic perfusion lung scintigraphy : validation with right heart catheterization
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- Jögi, Jonas (författare)
- Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
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- Al-Mashat, Mariam (författare)
- Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
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- Rådegran, Göran (författare)
- Lund University,Lunds universitet,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital
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- Bajc, Marika (författare)
- Lund University,Lunds universitet,Nuklearmedicinsk lungdiagnostik,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lung nuclear medicine diagnostics,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Arheden, Håkan (författare)
- Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2018-07-17
- 2018
- Engelska 9 s.
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 5:5, s. 902-910
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://onlinelibrar...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Aims: Pulmonary congestion remains a diagnostic challenge in patients with heart failure (HF). The recommended method, chest X-ray (CXR), lacks in accuracy, whereas quantitative tomographic lung scintigraphy [ventilation/perfusion single-photon emission computed tomography (V/P SPECT)] has shown promising results but needs independent validation. The aim of this study is to evaluate V/P SPECT as a non-invasive method to assess and quantify pulmonary congestion in HF patients, using right heart catheterization as reference method. The secondary objective was to investigate the performance of V/P SPECT in the clinical setting compared with CXR. Methods and results: Forty-six consecutive patients with HF that were under consideration for heart transplantation were studied prospectively. All participants were examined with V/P SPECT, CXR, and right heart catheterization. Pulmonary artery wedge pressure served as reference method. Quantitative perfusion gradients were derived from V/P SPECT images. Ventilation/perfusion single-photon emission computed tomography images were also assessed both by expert readers and clinical nuclear medicine physicians. Expert readers correctly identified 87% of all patients with an elevated pulmonary artery wedge pressure > 15 mmHg. The average sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for V/P SPECT assessed by the expert readers were 87%, 72%, 85%, and 75%, respectively. In the clinical nuclear medicine setting, V/P SPECT had 87% sensitivity, 63% specificity, 81% PPV, and 71% NPV. Clinically, V/P SPECT outperformed CXR, which had 27% sensitivity, 75% specificity, 67% PPV, and 35% NPV. Conclusions: Ventilation/perfusion single-photon emission computed tomography can be used as a non-invasive method to diagnose and quantify pulmonary congestion in patients with HF and is more accurate than CXR in diagnosing pulmonary congestion in the clinical setting.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- Heart failure
- Lung scintigraphy
- Pulmonary congestion
- Pulmonary perfusion distribution
- Right heart catheterization
- V/P SPECT
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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