Advanced

Cardiac output measured by electrical velocimetry in the CT suite correlates with coronary artery enhancement: A feasibility study

Flinck, Marianne; Graden, Asa; Milde, Helen; Flinck, Agneta; Hellstrom, Mikael; Björk, Jonas LU and Nyman, Ulf LU (2010) In Acta Radiologica 51(8). p.895-902
Abstract
Background: Cardiac output (CO) is inversely related to vascular contrast medium (CM) enhancement during computed tomography (CT). Impedance cardiography with a new technique, electrical velocimetry (EV), may create opportunities to measure CO pre-examination for adaptation of CM injection parameters. Purpose: To relate CO EV measured by radiology staff to aortic attenuation as a measure of coronary artery attenuation during CT coronary angiography (CTCA), and to formulate a tentative statistical model to adapt CM injection parameters to CO. Material and Methods: CO EV was measured immediately before 100 kVp CTCA (64-multirow detector) in 27 patients with presumed coronary artery disease. For CTCA, 260 mg I/kg (maximum dosage weight: 8090... (More)
Background: Cardiac output (CO) is inversely related to vascular contrast medium (CM) enhancement during computed tomography (CT). Impedance cardiography with a new technique, electrical velocimetry (EV), may create opportunities to measure CO pre-examination for adaptation of CM injection parameters. Purpose: To relate CO EV measured by radiology staff to aortic attenuation as a measure of coronary artery attenuation during CT coronary angiography (CTCA), and to formulate a tentative statistical model to adapt CM injection parameters to CO. Material and Methods: CO EV was measured immediately before 100 kVp CTCA (64-multirow detector) in 27 patients with presumed coronary artery disease. For CTCA, 260 mg I/kg (maximum dosage weight: 8090 kg for womenmen) was injected intravenously during 12 s. Simple linear regression analysis was performed to explore the correlation between aortic attenuation (Hounsfield units, HU) and body weight, the influence of CO EV on aortic attenuation adjusted to injected CM dose rate (HU per mg Ikgs), and to establish a tentative formula on how to adapt CM injection parameters to CO EV and desired aortic attenuation. Results: The correlation between aortic attenuation and body weight was weak and non-significant (r --0.14 after outlier exclusion). A significant negative correlation (r --0.63) was found between aortic attenuation adjusted to injected CM dose rate (HU per mg Ikgs) and CO EV. The resulting formula, CM dose rate = CO EV x (aortic attenuation -240)55, made it possible to calculate CM volumes and injection rates at various COs and, for example, the present mean aortic attenuation (438 HU), injection time (12 s), CM concentration (320 mg Iml), and a certain body weight. Conclusion: EV makes it possible to measure CO in the CT suite before vascular examinations. Hence, CM doses may be decreased in low CO states to reduce the risk of CM-induced nephropathy without jeopardizing diagnostic quality and may be increased in high CO states to avoid poor enhancement. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
nephropathy, contrast medium-induced, Contrast enhancement, coronary angiography
in
Acta Radiologica
volume
51
issue
8
pages
895 - 902
publisher
John Wiley & Sons
external identifiers
  • wos:000281771700009
  • scopus:77956499674
ISSN
1600-0455
DOI
10.3109/02841851.2010.503663
language
English
LU publication?
yes
id
69a9870e-fc97-4fe6-b145-e3b75418e07e (old id 1728182)
date added to LUP
2010-11-22 12:39:54
date last changed
2018-05-29 11:12:38
@article{69a9870e-fc97-4fe6-b145-e3b75418e07e,
  abstract     = {Background: Cardiac output (CO) is inversely related to vascular contrast medium (CM) enhancement during computed tomography (CT). Impedance cardiography with a new technique, electrical velocimetry (EV), may create opportunities to measure CO pre-examination for adaptation of CM injection parameters. Purpose: To relate CO EV measured by radiology staff to aortic attenuation as a measure of coronary artery attenuation during CT coronary angiography (CTCA), and to formulate a tentative statistical model to adapt CM injection parameters to CO. Material and Methods: CO EV was measured immediately before 100 kVp CTCA (64-multirow detector) in 27 patients with presumed coronary artery disease. For CTCA, 260 mg I/kg (maximum dosage weight: 8090 kg for womenmen) was injected intravenously during 12 s. Simple linear regression analysis was performed to explore the correlation between aortic attenuation (Hounsfield units, HU) and body weight, the influence of CO EV on aortic attenuation adjusted to injected CM dose rate (HU per mg Ikgs), and to establish a tentative formula on how to adapt CM injection parameters to CO EV and desired aortic attenuation. Results: The correlation between aortic attenuation and body weight was weak and non-significant (r --0.14 after outlier exclusion). A significant negative correlation (r --0.63) was found between aortic attenuation adjusted to injected CM dose rate (HU per mg Ikgs) and CO EV. The resulting formula, CM dose rate = CO EV x (aortic attenuation -240)55, made it possible to calculate CM volumes and injection rates at various COs and, for example, the present mean aortic attenuation (438 HU), injection time (12 s), CM concentration (320 mg Iml), and a certain body weight. Conclusion: EV makes it possible to measure CO in the CT suite before vascular examinations. Hence, CM doses may be decreased in low CO states to reduce the risk of CM-induced nephropathy without jeopardizing diagnostic quality and may be increased in high CO states to avoid poor enhancement.},
  author       = {Flinck, Marianne and Graden, Asa and Milde, Helen and Flinck, Agneta and Hellstrom, Mikael and Björk, Jonas and Nyman, Ulf},
  issn         = {1600-0455},
  keyword      = {nephropathy,contrast medium-induced,Contrast enhancement,coronary angiography},
  language     = {eng},
  number       = {8},
  pages        = {895--902},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {Cardiac output measured by electrical velocimetry in the CT suite correlates with coronary artery enhancement: A feasibility study},
  url          = {http://dx.doi.org/10.3109/02841851.2010.503663},
  volume       = {51},
  year         = {2010},
}