Determination of cardiac output with dynamic contrast-enhanced computed tomography

Michael Pienn, Gabor Kovacs, Maria Tscherner, Thorsten R Johnson, Peter Kullnig, Rudolf Stollberger, Andrea Olschewski, Horst Olschewski, Zoltán Bálint

Research output: Contribution to journalArticlepeer-review


Cardiac output (CO) is an important diagnostic and prognostic factor in the haemodynamic evaluation of patients. The gold standard for CO measurement, thermodilution, requires an invasive right-heart catheterisation (RHC). In this pilot study we aimed to determine the accuracy of non-invasive CO determination from dynamic contrast-enhanced computed tomography (CT) compared to thermodilution. Patients who underwent diagnostic or follow-up RHC due to suspected or known pulmonary vascular disease at our department and required a thoracic CT between June 2011 and August 2012 were included. CO was determined from CT attenuation-time curves in the pulmonary artery and the ascending aorta using a dynamic contrast-enhanced CT sequence. CO determined in N = 18 patients by dynamic CT in the pulmonary artery was in very good agreement with thermodilution data (r = 0.84). Bland-Altman analysis showed a systematic overestimation of 0.7 ± 0.6 l/min compared to thermodilution. Data from the ascending aorta also showed a good correlation, but with a larger scattering of the values. The average effective dose for the dynamic investigation was 1.2 ± 0.7 mSv. CO determined with dynamic contrast-enhanced CT in the main pulmonary artery reliably predicts the values obtained by thermodilution during RHC. This non-invasive technique might provide an alternative for repeated invasive right-heart catheter investigations in the follow-up of pulmonary arterial hypertension patients.

Original languageEnglish
Pages (from-to)1871-8
Number of pages8
JournalThe International Journal of Cardiovascular Imaging
Issue number8
Publication statusPublished - Dec 2013


  • Adult
  • Aged
  • Aorta
  • Aortography
  • Cardiac Catheterization
  • Cardiac Output
  • Contrast Media
  • Familial Primary Pulmonary Hypertension
  • Female
  • Humans
  • Hypertension, Pulmonary
  • Iohexol
  • Male
  • Middle Aged
  • Pilot Projects
  • Predictive Value of Tests
  • Pulmonary Artery
  • Radiation Dosage
  • Radiographic Image Interpretation, Computer-Assisted
  • Reproducibility of Results
  • Thermodilution
  • Time Factors
  • Tomography, X-Ray Computed
  • Comparative Study
  • Evaluation Studies
  • Journal Article


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