Olivier Lairez1,2,3,4, Clément Delmas5,6, Pauline Fournier5,7, Emmanuelle Cassol8,6, Simon Méjean8,5,7,6, Pierre Pascal8,7, Antoine Petermann7,9, Camille Dambrin6,10, Vincent Minville6,11, Didier Carrié5,7,12, Hervé Rousseau7,6,9, Michel Galinier5,7,6, Jérôme Roncalli5,12, Bertrand Marcheix6,10, Isabelle Berry8,7,6. 1. Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France. lairez@gmail.com. 2. Department of Cardiology, University Hospital of Rangueil, Toulouse, France. lairez@gmail.com. 3. Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France. lairez@gmail.com. 4. Medical School of Rangueil, University Paul Sabatier, Toulouse, France. lairez@gmail.com. 5. Department of Cardiology, University Hospital of Rangueil, Toulouse, France. 6. Medical School of Rangueil, University Paul Sabatier, Toulouse, France. 7. Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France. 8. Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France. 9. Department of Radiology, Toulouse University Hospital, Toulouse, France. 10. Department of Cardiac Surgery, Toulouse University Hospital, Toulouse, France. 11. Department of Anesthesiology, Toulouse University Hospital, Toulouse, France. 12. Medical School of Purpan, University Paul Sabatier, Toulouse, France.
Abstract
BACKGROUND: Left ventricular assist devices (LVADs) require serial assessment of right and left ventricular (RV & LV) volumes and function. Because the RV is not assisted, its function is a critical determinant of the hemodynamic and contributes significantly to postoperative morbidity and mortality. We evaluated the feasibility and the accuracy of tomographic-equilibrium radionuclide ventriculography (t-ERV) for the assessment of patients with LVADs. METHODS: Twenty-four patients with LVAD underwent t-ERV. Because of the limited acoustic window, transthoracic echocardiography (TTE) was only feasible in 19 patients. Functional evaluation including six-minute walk test (6MWT) and peak oxygen consumption (POC) was performed in 18 patients. Nine patients underwent a cardiac multidetector computed tomography (MDCT). Eight patients underwent a second evaluation by ERV 4.3 ± 1.4 months later. RESULTS: Reliability between t-ERV and MDCT for LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, RV end-diastolic volume, RV end-systolic volume, and RV ejection fraction (RVEF) was 0.900 (P = .001), 0.911 (P = .001), 0.765 (P = .021), 0.728 (P = .042), 0.875 (P = .004), and 0.781 (P = .023), respectively. There was no correlation between t-ERV and RV systolic parameters assessed by TTE. RVEF was correlated with POC (R = 0.521; P = .027). A cut-off value of 40% for RVEF measured by t-ERV could discriminate patients with poor functional status (P = .048 for NYHA stage; P = .016 for 6MWT and P = .007 for POC). CONCLUSION: t-ERV is a simple, reproducible, and an accurate technique for the assessment of RV function in patients with LVADs and warrants consideration in the evaluation and monitoring of symptomatic patients.
BACKGROUND: Left ventricular assist devices (LVADs) require serial assessment of right and left ventricular (RV & LV) volumes and function. Because the RV is not assisted, its function is a critical determinant of the hemodynamic and contributes significantly to postoperative morbidity and mortality. We evaluated the feasibility and the accuracy of tomographic-equilibrium radionuclide ventriculography (t-ERV) for the assessment of patients with LVADs. METHODS: Twenty-four patients with LVAD underwent t-ERV. Because of the limited acoustic window, transthoracic echocardiography (TTE) was only feasible in 19 patients. Functional evaluation including six-minute walk test (6MWT) and peak oxygen consumption (POC) was performed in 18 patients. Nine patients underwent a cardiac multidetector computed tomography (MDCT). Eight patients underwent a second evaluation by ERV 4.3 ± 1.4 months later. RESULTS: Reliability between t-ERV and MDCT for LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, RV end-diastolic volume, RV end-systolic volume, and RV ejection fraction (RVEF) was 0.900 (P = .001), 0.911 (P = .001), 0.765 (P = .021), 0.728 (P = .042), 0.875 (P = .004), and 0.781 (P = .023), respectively. There was no correlation between t-ERV and RV systolic parameters assessed by TTE. RVEF was correlated with POC (R = 0.521; P = .027). A cut-off value of 40% for RVEF measured by t-ERV could discriminate patients with poor functional status (P = .048 for NYHA stage; P = .016 for 6MWT and P = .007 for POC). CONCLUSION: t-ERV is a simple, reproducible, and an accurate technique for the assessment of RV function in patients with LVADs and warrants consideration in the evaluation and monitoring of symptomatic patients.
Entities:
Keywords:
Left ventricular assist device; SPECT; cardiac imaging; equilibrium radionuclide ventriculography; right ventricle
Authors: Andrei Todica; Johannes Siebermair; Julia Schiller; Mathias J Zacherl; Wolfgang P Fendler; Steffen Massberg; Peter Bartenstein; Clemens C Cyran; Stefan Kääb; Marcus Hacker; Reza Wakili; Sebastian Lehner Journal: J Nucl Cardiol Date: 2018-12-17 Impact factor: 5.952