Quantitative determination of aortic regurgitant volumes in dogs by ultrafast computed tomography

Current imaging modalities can provide only a qualitative or semiquantitative measure of the severity of aortic regurgitation. Ultrafast computed tomography (CT) has the capability of rapid imaging (17 frames/sec) coupled with high spatial resolution (1.5 mm2). Eight millimeter thick images can be acquired to interrogate simultaneously the right and left ventricles. End-diastolic and end-systolic tomograms can be reconstructed serially from apex to base by Simpson's rule to provide end-diastolic and end-systolic volumes from which the right and left ventricular stroke volumes can be derived. To determine whether the difference between left and right ventricular stroke volume measured with ultrafast CT could be used to estimate the volume of experimentally induced aortic regurgitation, we studied six dogs in which proximal aortic electromagnetic flow probes had been implanted. Varying degrees of aortic regurgitation were induced by manipulation of a basket catheter through the aortic valve. During suspended respiration in the control state in the absence of aortic regurgitation, right and left ventricular stroke volumes measured with ultrafast CT were nearly identical (mean difference 1.0 +/- 1.2 ml [mean +/- SE]). In the presence of varying degrees of aortic regurgitation, regurgitant volume derived by ultrafast CT as the difference between right and left ventricular stroke volumes correlated closely to the regurgitant volume measured by the electromagnetic flow probe (r = .99, slope = .92, y intercept = 0.98 ml, SEE = 1.02 ml, n = 16). Regurgitant fraction also correlated closely to the regurgitant fraction measured by the electromagnetic flow probe (r = .94, slope = .98, y intercept = 0.66%, SEE = 4.73%, n = 16).(ABSTRACT TRUNCATED AT 250 WORDS)