Jørgen Frøkiær

Quantitative Estimation of Extravascular Lung Water Volume and Preload by dynamic 15O-water Positron Emission Tomography

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Quantitative Estimation of Extravascular Lung Water Volume and Preload by dynamic 15O-water Positron Emission Tomography. / Nielsen, Bent Roni Ranghøj; Sørensen, Jens; Tolbod, Lars Poulsen; Alstrup, Aage Kristian Olsen; Iversen, Peter; Frederiksen, Christian Alcaraz; Wiggers, Henrik; Jorsal, Anders; Frøkiær, Jørgen; Harms, Hans.

In: European Heart Journal Cardiovascular Imaging, Vol. 20, No. 10, 18.03.2019, p. 1120-1128.

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@article{4a3197039bd44ce5a6696097a70bf03e,
title = "Quantitative Estimation of Extravascular Lung Water Volume and Preload by dynamic 15O-water Positron Emission Tomography",
abstract = "Aim: Left ventricular filling pressure (preload) can be assessed by pulmonary wedge pressure (PCWP) during pulmonary arterial catherization (PAC). An emerging method (PICCO) can estimate preload by global end-diastolic volume (GEDV) and congestion as extravascular lung water content (EVLW). However, no reliable quantitative non-invasive methods are available. Hence, in a porcine model of pulmonary congestion, we evaluated EVLW and GEDV by positron emission tomography (PET). The method was applied in 35 heart failure (HF) patients and 9 healthy volunteers. Methods and Results: Eight pigs were studied. Pulmonary congestion was induced by a combination of beta-blockers, angiotensin-2 agonist and saline infusion. PAC, PICCO, computerized tomography and 15O-H2O-PET was performed. EVLW increased from 521±76 mL to 973±325 ml (p<0.001) and GEDV from 1068±170 ml to 1254±85 ml (p<0.001). 15O-H2O-PET measures of EVLW increased from 566±151 ml to 797±231 ml (p<0.001) and GEDV from 364±60 ml to 524±92 ml (p<0.001). Both EVLW and GEDV measured with PICCO and 15O-H2O-PET correlated (r2=0.40, p<0.001; r2=0.40, p<0.001, respectively). EVLW correlated with Hounsfield units (HU) (PICCO: r2=0.36 p<0.001, PET: r2=0.46 p<0.001) and GEDV with PCWP (PICCO: r2=0.20 p=0.01, PET: r2=0.29 p=0.002). In human subjects, measurements were indexed (I) for body surface area. Neither EVLWI nor HU differed between chronic stable HF patients and healthy volunteers (p=0.11, p=0.29) whereas GEDVI was increased in HF patients (336±66 ml/m2 vs. 276±44 ml/m2, p=0.01). Conclusion: The present study demonstrates that 15O-H2O-PET can assess pulmonary congestion and preload quantitatively. Hence, prognostic information from 15O-H2O-PET examinations should be evaluated in clinical trials.",
author = "Nielsen, {Bent Roni Rangh{\o}j} and Jens S{\o}rensen and Tolbod, {Lars Poulsen} and Alstrup, {Aage Kristian Olsen} and Peter Iversen and Frederiksen, {Christian Alcaraz} and Henrik Wiggers and Anders Jorsal and J{\o}rgen Fr{\o}ki{\ae}r and Hans Harms",
year = "2019",
month = mar,
day = "18",
doi = "10.1093/ehjci/jez038",
language = "English",
volume = "20",
pages = "1120--1128",
journal = "European Heart Journal Cardiovascular Imaging",
issn = "1525-2167",
publisher = "Oxford University Press",
number = "10",

}

RIS

TY - JOUR

T1 - Quantitative Estimation of Extravascular Lung Water Volume and Preload by dynamic 15O-water Positron Emission Tomography

AU - Nielsen, Bent Roni Ranghøj

AU - Sørensen, Jens

AU - Tolbod, Lars Poulsen

AU - Alstrup, Aage Kristian Olsen

AU - Iversen, Peter

AU - Frederiksen, Christian Alcaraz

AU - Wiggers, Henrik

AU - Jorsal, Anders

AU - Frøkiær, Jørgen

AU - Harms, Hans

PY - 2019/3/18

Y1 - 2019/3/18

N2 - Aim: Left ventricular filling pressure (preload) can be assessed by pulmonary wedge pressure (PCWP) during pulmonary arterial catherization (PAC). An emerging method (PICCO) can estimate preload by global end-diastolic volume (GEDV) and congestion as extravascular lung water content (EVLW). However, no reliable quantitative non-invasive methods are available. Hence, in a porcine model of pulmonary congestion, we evaluated EVLW and GEDV by positron emission tomography (PET). The method was applied in 35 heart failure (HF) patients and 9 healthy volunteers. Methods and Results: Eight pigs were studied. Pulmonary congestion was induced by a combination of beta-blockers, angiotensin-2 agonist and saline infusion. PAC, PICCO, computerized tomography and 15O-H2O-PET was performed. EVLW increased from 521±76 mL to 973±325 ml (p<0.001) and GEDV from 1068±170 ml to 1254±85 ml (p<0.001). 15O-H2O-PET measures of EVLW increased from 566±151 ml to 797±231 ml (p<0.001) and GEDV from 364±60 ml to 524±92 ml (p<0.001). Both EVLW and GEDV measured with PICCO and 15O-H2O-PET correlated (r2=0.40, p<0.001; r2=0.40, p<0.001, respectively). EVLW correlated with Hounsfield units (HU) (PICCO: r2=0.36 p<0.001, PET: r2=0.46 p<0.001) and GEDV with PCWP (PICCO: r2=0.20 p=0.01, PET: r2=0.29 p=0.002). In human subjects, measurements were indexed (I) for body surface area. Neither EVLWI nor HU differed between chronic stable HF patients and healthy volunteers (p=0.11, p=0.29) whereas GEDVI was increased in HF patients (336±66 ml/m2 vs. 276±44 ml/m2, p=0.01). Conclusion: The present study demonstrates that 15O-H2O-PET can assess pulmonary congestion and preload quantitatively. Hence, prognostic information from 15O-H2O-PET examinations should be evaluated in clinical trials.

AB - Aim: Left ventricular filling pressure (preload) can be assessed by pulmonary wedge pressure (PCWP) during pulmonary arterial catherization (PAC). An emerging method (PICCO) can estimate preload by global end-diastolic volume (GEDV) and congestion as extravascular lung water content (EVLW). However, no reliable quantitative non-invasive methods are available. Hence, in a porcine model of pulmonary congestion, we evaluated EVLW and GEDV by positron emission tomography (PET). The method was applied in 35 heart failure (HF) patients and 9 healthy volunteers. Methods and Results: Eight pigs were studied. Pulmonary congestion was induced by a combination of beta-blockers, angiotensin-2 agonist and saline infusion. PAC, PICCO, computerized tomography and 15O-H2O-PET was performed. EVLW increased from 521±76 mL to 973±325 ml (p<0.001) and GEDV from 1068±170 ml to 1254±85 ml (p<0.001). 15O-H2O-PET measures of EVLW increased from 566±151 ml to 797±231 ml (p<0.001) and GEDV from 364±60 ml to 524±92 ml (p<0.001). Both EVLW and GEDV measured with PICCO and 15O-H2O-PET correlated (r2=0.40, p<0.001; r2=0.40, p<0.001, respectively). EVLW correlated with Hounsfield units (HU) (PICCO: r2=0.36 p<0.001, PET: r2=0.46 p<0.001) and GEDV with PCWP (PICCO: r2=0.20 p=0.01, PET: r2=0.29 p=0.002). In human subjects, measurements were indexed (I) for body surface area. Neither EVLWI nor HU differed between chronic stable HF patients and healthy volunteers (p=0.11, p=0.29) whereas GEDVI was increased in HF patients (336±66 ml/m2 vs. 276±44 ml/m2, p=0.01). Conclusion: The present study demonstrates that 15O-H2O-PET can assess pulmonary congestion and preload quantitatively. Hence, prognostic information from 15O-H2O-PET examinations should be evaluated in clinical trials.

U2 - 10.1093/ehjci/jez038

DO - 10.1093/ehjci/jez038

M3 - Journal article

C2 - 30887037

VL - 20

SP - 1120

EP - 1128

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

SN - 1525-2167

IS - 10

ER -