2004 OPEN FORUM Abstracts
THE CORRELATIONS BETWEEN RIGHT HEART FAILURE AND THROMBIN ANTITHROMBIN COMPLEX AND PLASMINOGEN ACTIVATOR INHIBITOR -1 IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Young
Kim,M.D., Yoon Soo Jang,M.D.*, Hyeong Joong Kim,M.D.*, †
and Chul Min Ahn,M.D.*, †Departments
of Internal Medicine*, The Institute of Chest Disease†, Yonsei
University College of Medicine,Seoul,Korea
Background:
Cardiac catheterization and echocardiography are conventional ways to
measure right heart function. but the first pass radionuclide
angiography(RI angiography) has also been proven to be a relatively
accurate, simple and reproducible method for measuring right heart
function compared with echocardiography. These days, cardiac CT
angiography(CT angiography), a new technique for measuring right
heart function, is introduced and its usefulness is being
investigated. In chronic obstructive pulmonary disease(COPD)
patients, right heart failure develops from pulmonary hypertension.
Pulmonary vascular constriction with hypoxemia and activation of
coagulation factors are well known to be the cause of pulmonary
hypertension. However, the correlations between coagulation factors
and right heart failure are not yet studied enough in COPD patients.
The aims of this study are to investigate the usefulness of cardiac
CT angiography compared with the first pass RI angiography and to
analyze the correlations between right heart failure and plasma
thrombin antithrombin complex(TAT) and plasminogen activator
inhibitor-1(PAI-1) levels.
Methods: The RI angiography and CT
angiography were performed on 15 patients who were diagnosed as COPD
to measure right heart function by measuring right ventricular
ejection fraction. and pulmonary function test was performed. Plasma
TAT and PAI-1 level were measured by enzyme linked immunoassay.
Results: Right heart function(right ventricular ejection
fraction) measured by CT angiography showed significant correlation
with right heart function(right ventricular ejection fraction)
measured by the RI angiography in COPD patients(p=0.000). Plasma TAT
level showed significantly inverted correlation with right heart
function measured by the first pass RI angiography(p=0.045) and CT
angiography(p=0.008). But plasma PAI-1 level showed no correlation
with right heart function measured by the first pass RI
angiography(p=0.470) and CT angiography(p=0.874).
Conclusions:
The present study demonstrates that CT angiography is an accurate and
useful method for measuring right heart function compared with the RI
angiography and plasma TAT level is closely related with right heart
failure in COPD patients.