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Correlation of a scintigraphic pulmonary perfusion index with hemodynamic parameters in patients with pulmonary artery hypertension

¹ Nuclear Medicine; ² Pulmonary, North Shore-Long Island Jewish Health System, Manhasset, New York

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Objectives: To determine if the perfusion index (PI) can be used as a simple, noninvasive measure of the severity of disease in pts with pulmonary artery hypertension (PAH).

Methods: 22 pts were included in this retrospective investigation: 9 controls & 13 pts with PAH. Controls had no evidence of PAH (mean pulmonary arterial pressure (MPAP) <25 mm Hg & pulmonary capillary wedge pressure (PCWP) <=18 mm Hg). Study pts had PAH (MPAP >= 25mm Hg & PCWP <=18 mm Hg) & no diagnosis of pulmonary embolism. Due to the retrospective nature of the study, the PI was calculated from the posterior perfusion image of a ventilation perfusion scan. Each perfusion image was assessed to determine the percent of extrapulmonary activity vs pulmonary activity. If this activity > 10% of maximum lung value, pts were excluded from the investigation (n=27). PI was computed (Fukuchi et al JNM June 2002) as 100 times the sum of the absolute values of the differences versus controls for the 9 deciles above background.

Results: Linear correlations vs. PI were significant for the following: pulmonary vascular resistance (r=0.81, p=0.00009), total pulmonary vascular resistance (MPAP/cardiac output) (r=0.80, p=0.00013), pulmonary artery systolic pressure (r=0.73, p=0.00018), MPAP (r=0.72, p=0.00022), pulmonary diastolic pressure (r=0.53, p=0.01) and right atrial pressure (r=0.50, p=0.03). Using logistic regression the PI was significant in separating pts with PAH from control pts (2=5.6, p=0.02).

Conclusions: The data suggest that PI can be used for the noninvasive diagnosis & measurement of severity of pulmonary artery hypertension.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Babchyck, B. Articles by Talwar, A. PubMed Articles by Babchyck, B. Articles by Talwar, A.