The detection of abnormal pulmonary capillary wedge pressure from the distribution of regional pulmonary blood volume on the gated blood pool scan

Abstract

THE DETECTION OF ABNORMAL PULMONARY CAPILLARY HEDGE PRESSURE FROM THE DISTRIBUTION OF REGIONAL PUIMONARY BLOOD VOLUME ON THE GATED BLOOD POOL SCAN Adalberto Urbina, MD; Robert D. Okada, MD, FACC; Mary D. Osbakken. MD: Charles A. Boucher. MD. FACC: Gerald M. Pohost, MD, FACC; H. William Strauss, MD, FACC; Igor Palacios, MD, Massachusetts General Hospital, Boston, MA To determine if the apex-to-base relative distribution of pulmonary blood volume obtained from gated blood pool scans could be used as a noninvasive method to estimate pulmonary capillary wedge pressure (PCWP), 77 patients had PCWP determination at cardiac catheterization and gated blood pool scans within 15 days of catheterization (47% within 24 hours, including 10 simultaneous measurements). The relative distribution of pulmonary blood volume at the apex and base of the lung was determined from the end-systolic left anterior oblique view frame by placing equal-sized regions-of-interest over the right lung. Apex counts divided by base counts (A/B ratio) was considered abnormal if >l. Ejection fraction (EF) was also calculated from the gated blood pool scan and considered abnormal if ~45%. The PCWP was considered normal if 512 mm Hg and abnormal if >12 mm Hg.