Dynamic Chest Radiography in Heart Failure

A less invasive method for assessing the hemodynamics of heart failure is dynamic chest radiography, says an article published in the European Journal of Radiology.

A significant public health issue that frequently results in hospitalization and death is heart failure. Atypical hemodynamics, with or without decreased cardiac output, define it. Right cardiac catheterization is more invasive than dynamic chest radiography. It is a large-field-of-view, real-time image-capturing system that combines imaging of the thorax with high spatial and temporal resolution with computer-assisted tracking of moving thoracic components. Cardiopulmonary blood flow may be evaluated non-invasively using dynamic chest radiography. Data on its application for heart failure hemodynamic evaluation, however, are limited. To determine heart failure hemodynamics, Hiroaki Hiraiwa and team used dynamic chest radiography.

Twenty patients with heart failure (median age, 67 years; 17 males) received right cardiac catheterization and dynamic chest radiography. The pictures under analysis were 16-bit images (grayscale range: 0–65,535). The average of the grayscale values of each pixel within a region of interest was used to calculate the pixel values for the right atrium, right pulmonary artery, and left ventricular apex. Researchers examined the relationships between right atrial pressure, pulmonary artery wedge pressure, pulmonary artery pressure, and cardiac index, as well as the lowest, maximum, amount of change, mean, and rate of change in pixel values.

Key Findings

• There was a correlation between the mean right atrial pixel value and the mean right atrial pressure, as well as between the mean right pulmonary artery pixel value and the mean pulmonary artery pressure (R = 0.546, P = 0.013), the mean left ventricular apex pixel value change rate and the mean pulmonary artery wedge pressure (R = 0.664, P = 0.001), or the cardiac index (R = 0.606, P = 0.005).
• Low cardiac index was shown to be associated with high pulmonary artery wedge pressure and low cardiac index alone.

In conclusion, dynamic chest radiography shows promise as a less invasive alternative to right heart catheterization and is practical for heart failure hemodynamic evaluation.

Reference

Hiraiwa, H., Sakamoto, G., Ito, R., Koyama, Y., Kazama, S., Kimura, Y., Kondo, T., Morimoto, R., Okumura, T., & Murohara, T. (2023). Dynamic chest radiography as a novel minimally invasive hemodynamic imaging method in patients with heart failure. In European Journal of Radiology (p. 110729). Elsevier BV. https://doi.org/10.1016/j.ejrad.2023.110729