Hemodynamic Characteristics of Abnormal Distribution of Pulmonary Blood Flow in Patients with Cardiac Disorders

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Lung profile scanning using I131 labeled macroaggregated albumin (I131-MAA) was presented as a quantitative estimation of regional pulmonary blood flow. Distribution index in four parts of the lungs (right, left, upper, and lower) was calculated from the area under MAA-pulmogram.Characteristics of the impaired distribution of pulmonary arterial flow in cardiac diseases were elevation of U/L ratio which consisted of decrease of blood flow in the lower zone associated with increase in the upper zone.Increased U/L ratio was more characteristic in the patients with left heart failure than with any other specific diseases. From the correlation with hemodynamic variables obtained by the combined right and transseptal left heart catheterizations, increased U/L ratio was found to correlate significantly with left atrial mean pressure. Left atrial mean pressure below 10mm.Hg did not make U/L ratio elevate. When it exceeded 10mm.Hg U/L ratio was observed to increase linearly in proportion to the increased left atrial mean pressure. These facts are well explained by the interstitial perivascular edema of the dependent zone in the isolated perfused dog lung which was first introduced by West et al. in 1965. This external counting technique using I131-MAA is clinically useful to estimate the severity of various acquired cardiac diseases.
International Heart Journal刊行会の論文