Influence of Blood Viscosity on Circulatory Parameters Determined by First-Pass Radionuclide Angiocardiography in Cor pulmonale

Summary

First-pass radionuclide angiocardiography (FPRNA) with ^99mTc-albumin was performed in 19 patients with cor pulmonale. Pulmonary circulation time (PCT), mean transit time (MTT), pulmonary stagnation index (PSI) were calculated from the time-activity curves for the estimation of cardiopulmonary circulation. Whole blood viscosity (WBV), plasma viscosity (PV) and hematocrit (HTC) were also measured on the same day. Significant prolongation of all parameters was observed (WBW: 5,04 ± 1.19 mPas; PV: 1,36 ± 0,17 mPas; HTC: 47,6 ±2,37%; PCT: 7,10 ± 2,15 s; MTT: 9,33 ±4,11 s; PSI: 1,30 ±0,37) in patients with cor pulmonale. Significant positive correlations were found between PCT and WBV (r = 0,552; 0,001 <P <0.01), MTT and WBV (r = 0,34; P <0,05), furthermore between PCT and HTC (r = 0,356; P <0,05). The results suggest that hemorheological parameters may influence the results of FPRNA, therefore, they should be determined in addition to the radionuclide study.

Zusammenfassung

Die First-Pass Untersuchung (FPRNA) mit ^99mTc-Albumin wurde bei 19 Patienten mit Cor pulmonale durchgeführt. Pulmonale Zirkulationszeit (PCT), »mean transit« Zeit (MTT), pulmonaler Rest Index (PSI) wurden ermittelt aus den Zeit-Aktivitätskurven zur Einschätzung des kardiopulmonalen Durchflusses. Vollblut-Viskosität (WBV), Plasma-Viskosität (PV) und Hämatokrit (HTC) wurden am selben Tag gemessen. Bezeichnend für Patienten mit Cor pulmonale war eine typische Vergrößerung aller Parameter (WBV: 5,04 ± 1,19 mPAS; PV: 1,36 ± 0,17 mPAS; HTC: 47,6±2,37%; PCT: 7,10±2,15s; MTT: 9,33 ±4,11 s; PSI: 1,30 ±0,37). Verwertbare Korrelationen wurden zwischen PCT und WBV (r = 0,552; 0,001 <p <0,01), MTT und WBV (r = 0,34; p <0,05) sowie zwischen PCT und HTC (r = 0,356; p <0,05) gefunden. Die Resultate zeigen, daß hämorheologische Parameter einen Einfluß auf die Werte der FPRNA haben. Deswegen sollten diese Bestimmungen stets zusammen mit der FPRNA durchgeführt werden.

Key words

First-pass radionuclide angiocardiography - cardiopulmonary circulation - Cor pulmonale - blood rheology

Schlüsselwörter

First-pass Untersuchung - kardiopulmonaler Durchfluß - Cor pulmonale - BlutRheologie

• References

• 1 Aarts PAMM, Heuvelmans JHA, Gaslinga H. Blood viscosity evaluation by regression analysis to differenciate for hematocrit. Clin Hemorheol 1989; 09: 583-92.
• 2 Adam WE, Geffers H, Siegel H, Bitter F, Kampmann H, Stauch M, Wassermann B. Evaluation of left ventricular function by radionuclide angiography. Herz 1977; 02: 195-9.
• 3 Barbee JH, Cokelet GR. Prediction of blood flow in tubes with diameters as small as 29 1m. Microvasc Res 1971; 03: 17-21.
• 4 Begg TB, Hearus JB. Components in blood viscosity. Clin Sei 1966; 31: 87-93.
• 5 Bisi G, Sciagra R, Büll V, Britton KE, Eilles C, Eißner O, Hahn K, Höffken H, Joseph K, McKillop J, Larock MP, Müller S, Reiners C, Rigo P. Assessment of ventricular function with first-pass radionuclide angiography using technetium 99m hexakis- 2-methoxyisobutylisonitrile: a European multicentre study. Eur J Nucl Med 1991; 18: 178-83.
• 6 Chien S. Haemorheology in disease, pathophysiological significance and therapeutic implications. Clin Hemorheol 1981; 01: 419-42.
• 7 Chien S. Haemorheology in clinical medicine. Clin Hemorheol 1982; 02: 137-42.
• 8 Dintenfass L. Viscosity factors in hypertensive and cardiovascular diseases. Cardiovasc Med 1977; 02: 337-54.
• 9 Donato L, Rochester OF, Lewis L, Durand J, Parker JO, Harvey RM. Quantitative radiocardiography I. Theoretical considerations II. Technic and analysis of curves III. Results and validation of theory and method. Circulation 1962; 25: 674-86.
• 10 Dormandy JA. Measurement of whole- blood viscosity. In: Clinical Aspects of Blood Viscosity and Cell Deformability. Lowe GDO, Barbenel JC, Forbes CD. (eds). Berlin, Heidelberg, New York: Springer-Verlag; 1981: 67-78.
• 11 Ehrly AM. On the relationship between microcirculation and hemorheology in clinical medicine: New aspects and strategies. Clin Hemorheol 1989; 09: 461.
• 12 Pillay M, Rezvani M, Cox PH. Changes in pulmonary mean transit time demonstrated by the scintigraphic first pass technique in patients receiving radiation therapy. Eur J Nucl Med 1987; 13: 305-6.
• 13 Schmid-Schönbein H. Interaction of vaso- motion and blood rheology in haemodyna- mics. In: Clinical Aspects of Blood Viscosity and Cell Deformability. Lowe GDO, Barbenel JC, Forbes CD. (eds). Berlin, Heidelberg, New York: Springer-Verlag; 1981: 49-66.
• 14 Tóth K, Mezey B, Juricskay I, Jávor T. The role of hemorheological parameters in the cardiological differential diagnostics – especially in IHD and myocarditis. Clin Hemorheol 1989; 09: 529.
• 15 Zámbó K, Nemessányi Z. Estimation of cardiopulmonary circulation using first-pass radionuclide angiography. Radiol diagn. 1993 34/1: 45-7.