Measurement of cardiac output by cine computed tomography

High-speed computed transmission tomography (cine CT) is a new noninvasive technique that may be useful for the rapid, accurate quantitation of cardiac function. The capability of cine CT to assess cardiac output was examined 10 mongrel dogs as an initial step in validating this method. After the dogs were anesthetized, femoral arterial pressure and pulmonary artery thermodilution catheters were inserted. After intravenous injection of a bolus of contrast medium, cine CT scans were performed in the flow mode, in which 50-ms scans were triggered electrocardiographically at end-diastole at 8 levels during sequential cardiac cycles. Scans and thermodilution measurements of cardiac output were obtained at rest and during altered hemodynamic states induced by separate infusions of dobutamine and phenylephrine. Time-density analysis was performed over the left ventricular cavity and curves were fitted to the CT flow data by gamma-variate analysis. Using the Stewart-Hamilton equation established for indicator dilution techniques, the cardiac output was calculated. The results established a direct linear correlation (r = 0.92) between cine CT cardiac output and thermodilution cardiac output over a wide range of cardiac outputs (1.5 to 6.3 liters/min). This study demonstrates that cine CT can provide a reliable estimate of cardiac output noninvasively using contrast medium as an indicator in dogs.