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Quantitative determination of regional extravascular lung water and regional blood volume in congestive heart failure

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Abstract

Regional extravascular lung water (rELW) and blood volume (rBV) in five controls and 14 patients with congestive heart failure (CHF) were measured by constant infusion of H2 15O and inhalation of 11CO using positron emission tomography (PET). The analysis of 18 regions per patient revealed a relatively homogenous level of rELW in the controls (x=0.11±0.02 g/cc; range, 0.08–0.21), whereas this increased in patients with CHF (0.17±0.02 g/cc; range, 0.10–0.51). The rBV was 0.21±0.02 g/cc in the controls and 0.17±0.02 g/cc in patients with CHF. A good correlation was found between the severity of chronic heart failure (according to the grading of the New York Heart Association) and mean extravascular lung water (ELW) (r=0.69), as well as between CHF and the ratio rELW/rBV (r=0.87); however, the correlation to hemodynamic data was less satisfactory (cardiac index, r=0.45; pulmonary capillary wedge pressure, r=0.47; ejection fraction, r=0.60). In supine controls, a progressive decrease in regional blood volume from the basal to the apical regions was observed, whereas the differences in ELW were only small. In patients with chronic heart failure, ELW in the basal parts was markedly increased, whereas in the apical regions, only minor deviations from the controls were observed. In the basal regions of these patients, the blood volume was reduced by about 30%. Instead of the normal basoapical gradient of blood volume, these patients showed a rather flat distribution. Radiographic findings of pulmonary edema generally appeared together with an ELW level of greater than 0.14 g/cc. We conclude that the amount and distribution of fluid in pulmonary congestion can be noninvasively assessed by PET.

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Authors and Affiliations

  1. Medical School Hannover, Hannover, Germany

    Otmar H. Schober M.D. Ph.D., Geerd-J. Meyer, Claus Bossaller, Hans Creutzig, Paul R. Lichtlen & Heinz Hundeshagen

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  1. Otmar H. Schober M.D. Ph.D.
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  2. Geerd-J. Meyer
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  3. Claus Bossaller
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  4. Hans Creutzig
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  5. Paul R. Lichtlen
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  6. Heinz Hundeshagen
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Dedicated to Prof. Dr. Hans-Stephan Stender on his 65th birthday

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Schober, O.H., Meyer, GJ., Bossaller, C. et al. Quantitative determination of regional extravascular lung water and regional blood volume in congestive heart failure. Eur J Nucl Med 10, 17–24 (1985). https://doi.org/10.1007/BF00261757

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