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Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis
Cerebral tissue oxygen saturation (SctO(2)) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We ai...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916527/ https://www.ncbi.nlm.nih.gov/pubmed/29689105 http://dx.doi.org/10.1371/journal.pone.0196299 |
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author | Chen, Yu-Jen Wang, Jong-Shyan Hsu, Chih-Chin Lin, Pyng-Jing Tsai, Feng-Chun Wen, Ming-Shien Kuo, Chi-Tai Huang, Shu-Chun |
author_facet | Chen, Yu-Jen Wang, Jong-Shyan Hsu, Chih-Chin Lin, Pyng-Jing Tsai, Feng-Chun Wen, Ming-Shien Kuo, Chi-Tai Huang, Shu-Chun |
author_sort | Chen, Yu-Jen |
collection | PubMed |
description | Cerebral tissue oxygen saturation (SctO(2)) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We aimed to investigate the association of SctO(2) with oxygen transport physiology and known prognostic factors during both rest and exercise in patients with HFrEF or stroke. Thirty-four HFrEF patients, 26 stroke patients, and 17 healthy controls performed an incremental cardiopulmonary exercise test using a bicycle ergometer. Integrated near-infrared spectroscopy and automatic gas analysis were used to measure cerebral tissue oxygenation and cardiac and ventilatory parameters. We found that SctO(2) (rest; peak) were significantly lower in the HFrEF (66.3±13.3%; 63.4±13.8%,) than in the stroke (72.1±4.2%; 72.7±4.5%) and control (73.1±2.8%; 72±3.2%) groups. In the HFrEF group, SctO(2) at rest (SctO(2rest)) and peak SctO(2) (SctO(2peak)) were linearly correlated with brain natriuretic peptide (BNP), peak oxygen consumption ([Image: see text] ), and oxygen uptake efficiency slope (r between -0.561 and 0.677, p < 0.001). Stepwise linear regression showed that SctO(2rest) was determined by partial pressure of end-tidal carbon dioxide at rest (P(ET)CO(2rest)), hemoglobin, and mean arterial pressure at rest (MAP(rest)) (adjusted R = 0.681, p < 0.05), while SctO(2peak) was mainly affected by peak carbon dioxide production ([Image: see text] ) (adjusted R = 0.653, p < 0.05) in patients with HFrEF. In conclusion, the study delineates the relationship of cerebral saturation and parameters associated with oxygen delivery. Moreover, SctO(2peak) and SctO(2rest) are correlated with some well-recognized prognostic factors in HFrEF, suggesting its potential prognostic value. |
format | Online Article Text |
id | pubmed-5916527 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-59165272018-05-05 Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis Chen, Yu-Jen Wang, Jong-Shyan Hsu, Chih-Chin Lin, Pyng-Jing Tsai, Feng-Chun Wen, Ming-Shien Kuo, Chi-Tai Huang, Shu-Chun PLoS One Research Article Cerebral tissue oxygen saturation (SctO(2)) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We aimed to investigate the association of SctO(2) with oxygen transport physiology and known prognostic factors during both rest and exercise in patients with HFrEF or stroke. Thirty-four HFrEF patients, 26 stroke patients, and 17 healthy controls performed an incremental cardiopulmonary exercise test using a bicycle ergometer. Integrated near-infrared spectroscopy and automatic gas analysis were used to measure cerebral tissue oxygenation and cardiac and ventilatory parameters. We found that SctO(2) (rest; peak) were significantly lower in the HFrEF (66.3±13.3%; 63.4±13.8%,) than in the stroke (72.1±4.2%; 72.7±4.5%) and control (73.1±2.8%; 72±3.2%) groups. In the HFrEF group, SctO(2) at rest (SctO(2rest)) and peak SctO(2) (SctO(2peak)) were linearly correlated with brain natriuretic peptide (BNP), peak oxygen consumption ([Image: see text] ), and oxygen uptake efficiency slope (r between -0.561 and 0.677, p < 0.001). Stepwise linear regression showed that SctO(2rest) was determined by partial pressure of end-tidal carbon dioxide at rest (P(ET)CO(2rest)), hemoglobin, and mean arterial pressure at rest (MAP(rest)) (adjusted R = 0.681, p < 0.05), while SctO(2peak) was mainly affected by peak carbon dioxide production ([Image: see text] ) (adjusted R = 0.653, p < 0.05) in patients with HFrEF. In conclusion, the study delineates the relationship of cerebral saturation and parameters associated with oxygen delivery. Moreover, SctO(2peak) and SctO(2rest) are correlated with some well-recognized prognostic factors in HFrEF, suggesting its potential prognostic value. Public Library of Science 2018-04-24 /pmc/articles/PMC5916527/ /pubmed/29689105 http://dx.doi.org/10.1371/journal.pone.0196299 Text en © 2018 Chen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Chen, Yu-Jen Wang, Jong-Shyan Hsu, Chih-Chin Lin, Pyng-Jing Tsai, Feng-Chun Wen, Ming-Shien Kuo, Chi-Tai Huang, Shu-Chun Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title | Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title_full | Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title_fullStr | Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title_full_unstemmed | Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title_short | Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis |
title_sort | cerebral desaturation in heart failure: potential prognostic value and physiologic basis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916527/ https://www.ncbi.nlm.nih.gov/pubmed/29689105 http://dx.doi.org/10.1371/journal.pone.0196299 |
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