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
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.