Effect of hyperoxia on left ventricular function and filling pressures in patients with and without congestive heart failure
Effect of hyperoxia on left ventricular function and filling pressures in patients with and without congestive heart failure
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DOI：
10.1378/chest.120.2.467
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发表时间：
2001-08-01
期刊：
影响因子：
9.6
通讯作者：
Newton, GE
中科院分区：
文献类型：
--
作者：
Mak, S;Azevedo, ER;Newton, GE
研究目的：目的：探讨高氧对充血性心力衰竭（CHF）患者左室功能的影响。设计：高氧对右心血流动力学、左室收缩力和舒张功能的急性生理学研究。（左心室压力上升的峰值正速率[+dP/dt]）、等容左心室舒张的时间常数（tau）和左心室充盈压。拜耳心血管临床研究实验室，西奈山医院，多伦多，安大略。患者：16名稳定CHF患者和12名LV功能正常的受试者接受高氧干预。干预：患者通过非再呼吸器面罩接受21%的O-2，随后接受20 min的100% O-2，以及10 min的21% O-2恢复期。作为对高氧的反应，CHF组的LV舒张末期压（LVEDP）增加了22 +/- 6%，而LV功能正常组的LVEDP增加了29 +/- 14%（两者p < 0.05;平均值SEM）。高氧也与CHF组延长10 +/- 2%（p < 0.05）和正常LV功能组延长8 +/- 2%（p < 0.05）相关。两组均未观察到+dP/dt的变化。结论：高氧与心衰患者的心脏舒张功能受损和左室充盈压增加有关。这些观察结果表明，应谨慎使用的管理高吸入的O-2分数的含氧量正常的患者，特别是在CHF的设置。
Study objectives: To determine the effects of hyperoxia on left ventricular (LV) function in humans with and without congestive heart failure (CHF).Design: An acute physiologic study of the effect of hyperoxia on right-heart hemodynamics, LV contractility (peak positive rate of rise of LV pressure [+dP/dt]), time constant of isovolumic left ventricular relaxation (tau), and LV filling pressures.Setting: Bayer Cardiovascular Clinical Research Laboratory at the Mount Sinai Hospital, Toronto, Ontario.Patients: Sixteen patients with stable CHF and 12 subjects with normal LV function received the hyperoxia intervention.Interventions: Patients received 21% O-2 by a nonrebreather mask, followed by 100% O-2 for 20 min, and 21% O-2 for a 10-min recovery period.Results: In response to hyperoxia, there was a 22 +/- 6% increase in LV end-diastolic pressure (LVEDP) in the CHF group and a similar 29 +/- 14% increase in LVEDP in the normal LV function group (p < 0.05 for both; mean SEM). Hyperoxia was also associated with a prolongation in of 10 +/- 2% in the CHF group (p < 0.05) and 8 +/- 2% in the normal LV function group (p < 0.05). No changes in +dP/dt were observed in either group.Conclusions: Hyperoxia was associated with impairment of cardiac relaxation and increased LV filling pressures in patients with and without CHF. These observations indicate that caution should be used in the administration of high inspired O-2 fractions to normoxic patients, especially in the setting of CHF.