Influence of oxygen tension on myocardial performance. Evaluation by tissue Doppler imaging

被引:30
作者
Frøbert O. [1 ,2 ]
Moesgaard J. [1 ]
Toft E. [3 ]
Poulsen S.H. [4 ]
Søgaard P. [1 ]
机构
[1] Department of Cardiology, Aalborg Hospital, Aarhus University Hospital
[2] Institute of Pharmacology, University of Aarhus
[3] Ctr. Model-based Med. Decis. S., Dept. of Hlth. Sci. and Technology, Aalborg University, Aalborg
[4] Skejby University Hospital, Aarhus
关键词
Diastolic Function; Tricuspid Regurgitation; Tissue Doppler Imaging; Left Ventricular Filling Pressure; Myocardial Performance;
D O I
10.1186/1476-7120-2-22
中图分类号
学科分类号
摘要
Background: Low O2 tension dilates coronary arteries and high O2 tension is a coronary vasoconstrictor but reports on O 2-dependent effects on ventricular performance diverge. Yet oxygen supplementation remains first line treatment in cardiovascular disease. We hypothesized that hypoxia improves and hyperoxia worsens myocardial performance. Methods: Seven male volunteers (mean age 38 ± 3 years) were examined with echocardiography at respiratory equilibrium during: 1) normoxia (≈21% O2, 79% N2), 2) while inhaling a hypoxic gas mixture (≈11% O2, 89% N2), and 3) while inhaling 100% O 2. Tissue Doppler recordings were acquired in the apical 4-chamber, 2-chamber, and long-axis views. Strain rate and tissue tracking displacement analyses were carried out in each segment of the 16-segment left ventricular model and in the basal, middle and apical portions of the right ventricle. Results: Heart rate increased with hypoxia (68 ± 4 bpm at normoxia vs. 79 ± 5 bpm, P < 0.001) and decreased with hyperoxia (59 ± 5 bpm, P < 0.001 vs. normoxia). Hypoxia increased strain rate in four left ventricular segments and global systolic contraction amplitude was increased (normoxia: 9.76 ± 0.41 vs hypoxia: 10.87 ± 0.42, P < 0.001). Tissue tracking displacement was reduced in the right ventricular segments and tricuspid regurgitation increased with hypoxia (7.5 ± 1.9 mmHg vs. 33.5 ± 1.8 mmHg, P < 0.001). The TEI index and E/E' did not change with hypoxia. Hyperoxia reduced strain rate in 10 left ventricular segments, global systolic contraction amplitude was decreased (8.83 ± 0.38, P < 0.001 vs. normoxia) while right ventricular function was unchanged. The spectral and tissue Doppler TEI indexes were significantly increased but E/E' did not change with hyperoxia. Conclusion: Hypoxia improves and hyperoxia worsens systolic myocardial performance in healthy male volunteers. Tissue Doppler measures of diastolic function are unaffected by hypoxia/hyperoxia which support that the changes in myocardial performance are secondary to changes in vascular tone. It remains to be settled whether oxygen therapy to patients with heart disease is a consistent rational treatment. © 2004 Frøbert et al; licensee BioMed Central Ltd.
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共 27 条
[1]  
Adams M.R., McCredie R., Jessup W., Robinson J., Sullivan D., Celermajer D.S., Oral L-arginine improves endothelium-dependent dilatation and reduces monocyte adhesion to endothelial cells in young men with coronary artery disease, Atherosclerosis, 129, pp. 261-269, (1997)
[2]  
Smith H.L., Sapsford D.J., Delaney M.E., Jones J.G., The effect on the heart of hypoxaemia in patients with severe coronary artery disease, Anaesthesia, 51, pp. 211-218, (1996)
[3]  
Boussuges A., Molenat F., Burnet H., Cauchy E., Gardette B., Sainty J.M., Jammes Y., Richalet J.P., Operation Everest III (Comex '97): Modifications of cardiac function secondary to altitude-induced hypoxia. An echocardiographic and Doppler study, Am J Respir Crit Care Med, 161, pp. 264-270, (2000)
[4]  
Fowles R.E., Hultgren H.N., Left ventricular function at high altitude examined by systolic time intervals and M-mode echocardiography, Am J Cardiol, 52, pp. 862-866, (1983)
[5]  
Alexander J.K., Grover R.F., Mechanism of reduced cardiac stroke volume at high altitude, Clin Cardiol, 6, pp. 301-303, (1983)
[6]  
Reeves J.T., Groves B.M., Sutton J.R., Wagner P.D., Cymerman A., Malconian M.K., Rock P.B., Young P.M., Houston C.S., Operation Everest II: Preservation of cardiac function at extreme altitude, J Appl Physiol, 63, pp. 531-539, (1987)
[7]  
Maruyama J., Tobise K., Kawashima E., The effect of acute hypoxia on left ventricular function with special reference to diastolic function - An analysis using ultrasonic method, Jpn Circ J, 56, pp. 998-1011, (1992)
[8]  
Mak S., Azevedo E.R., Liu P.P., Newton G.E., Effect of hyperoxia on left ventricular function and filling pressures in patients with and without congestive heart failure, Chest, 120, pp. 467-473, (2001)
[9]  
Isaaz K., Tissue Doppler imaging for the assessment of left ventricular systolic and diastolic functions, Curr Opin Cardiol, 17, pp. 431-442, (2002)
[10]  
Rees S.E., Kjaergaard S., Perthorgaard P., Malczynski J., Toft E., Andreassen S., The automatic lung parameter estimator (ALPE) system: Non-invasive estimation of pulmonary gas exchange parameters in 10-15 minutes, J Clin Monit Comput, 17, pp. 43-52, (2002)