Korean J Radiol.  2007 Feb;8(1):15-21. 10.3348/kjr.2007.8.1.15.

Assessment of the Right Ventricular Function and Mass Using Cardiac Multi-Detector Computed Tomography in Patients with Chronic Obstructive Pulmonary Disease

• Hur J
• Kim TH
• Kim SJ
• Ryu YH
• Kim HJ

• KMID: 753861
• DOI: http://doi.org/10.3348/kjr.2007.8.1.15

Abstract

OBJECTIVE
We wanted to assess the relationship between measurements of the right ventricular (RV) function and mass, with using cardiac multi-detector computed tomography (MDCT) and the severity of chronic obstructive pulmonary disease (COPD) as determined by the pulmonary function test (PFT). MATERIALS AND METHODS: Measurements of PFT and cardiac MDCT were obtained in 33 COPD patients. Using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, the patients were divided into three groups according to the severity of the disease: stage I (mild, n = 4), stage II (moderate, n = 15) and stage III (severe, n = 14). The RV function and the wall mass were obtained by cardiac MDCT. The results were compared among the groups using the Student-Newman-Keuls method. Pearson's correlation was used to evaluate the relationship between the right ventricular ejection fraction (RVEF) and the wall mass results with the PFT results. P-values less than 0.05 were considered statistically significant. RESULTS: The RVEF and mass were 47+/-3% and 41+/-2 g in stage I, 46+/-6% and 46+/-5 g in stage II, and 35+/-5% and 55+/-6 g in stage III, respectively. The RVEF was significantly lower in stage III than in stage I and II (p < 0.01). The RV mass was significantly different among the three stages, according to the disease severity of COPD (p < 0.05). The correlation was excellent between the MDCT results and forced expiratory volume in 1 sec (r = 0.797 for RVEF and r = -0.769 for RV mass) and forced expiratory volume in 1 sec to the forced vital capacity (r = 0.745 for RVEF and r = -0.718 for RV mass). CONCLUSION: Our study shows that the mean RV wall mass as measured by cardiac MDCT correlates well with the COPD disease severity as determined by PFT.

Keyword

Right ventricular function; Computed tomography (CT); Chronic obstructive pulmonary disease (COPD)

MeSH Terms

Ventricular Dysfunction, Right/*etiology/physiopathology/*radiography
Tomography, X-Ray Computed/*methods
Statistics, Nonparametric
Respiratory Function Tests
Pulmonary Disease, Chronic Obstructive/*complications/physiopathology
Middle Aged
Male
Humans
Female
Analysis of Variance
Aged

Figure

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  Fig. 1 Short-axis multiplanar reformation images in the end-diastolic and the end-systolic phases.

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  Fig. 2 Measurement of the right ventricular myocardial volume. The end systolic multiplanar reformation (A) and the end diastolic multiplanar reformation (B) images in the short-axis sections with markers indicate how the endocardial and the epicardial borders of these sections were traced. The myocardial mass was assessed using the following equation: myocardial mass = (epicardial volume-endocardial volume) *1.05 (the specific gravity of myocardium).

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  Fig. 3 The relationship between the measurements of the RV ejection fraction and the mass, and the FEV1 in 33 patients with COPD. A. The relationship between the measurements of the RV ejection fraction and FEV1, with the correlation coefficient of 0.797. B. The relationship between the measurements of the RV mass and FEV1, with the correlation coefficient of -0.769.

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  Fig. 4 The relationship between the measurements of the RV ejection fraction and the mass, and the FEV1/FVC in 33 patients with COPD. A. The relationship between the measurements of the RV ejection fraction and FEV1/FVC, with the correlation coefficient of 0.745. B. The relationship between the measurements of the RV mass and FEV1/FVC, with the correlation coefficient of -0.718.

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