Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease
Background The impact of hyperoxia, that is, supraphysiological arterial partial pressure of O2, on myocardial oxygen balance and function in stable multivessel coronary artery disease (CAD) is poorly understood. In this observational study, we assessed myocardial effects of inhalational hyperoxia i...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.014739 |
| _version_ | 1818314986646142976 |
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| author | Dominik P. Guensch Kady Fischer Kyohei Yamaji Silvia Luescher Yasushi Ueki Bernd Jung Gabor Erdoes Christoph Gräni Hendrik von Tengg‐Kobligk Lorenz Räber Balthasar Eberle |
| author_facet | Dominik P. Guensch Kady Fischer Kyohei Yamaji Silvia Luescher Yasushi Ueki Bernd Jung Gabor Erdoes Christoph Gräni Hendrik von Tengg‐Kobligk Lorenz Räber Balthasar Eberle |
| author_sort | Dominik P. Guensch |
| collection | DOAJ |
| description | Background The impact of hyperoxia, that is, supraphysiological arterial partial pressure of O2, on myocardial oxygen balance and function in stable multivessel coronary artery disease (CAD) is poorly understood. In this observational study, we assessed myocardial effects of inhalational hyperoxia in patients with CAD using a comprehensive cardiovascular magnetic resonance exam. Methods and Results Twenty‐five patients with stable CAD underwent a contrast‐free cardiovascular magnetic resonance exam in the interval between their index coronary angiography and subsequent revascularization. The cardiovascular magnetic resonance exam involved T1 and T2 mapping for tissue characterization (fibrosis, edema) as well as function imaging, from which strain analysis was derived, and oxygenation‐sensitive cardiovascular magnetic resonance imaging. The latter modalities were both acquired at room air and after breathing pure O2 by face mask at 10 L/min for 5 minutes. In 14 of the 25 CAD patients (56%), hyperoxia induced poststenotic myocardial deoxygenation with a subsequent oxygenation discordance across the myocardium. Extent of deoxygenation was correlated to degree of stenosis (r=−0.434, P=0.033). Hyperoxia‐associated poststenotic deoxygenation was accompanied by ipsiregional reduction of diastolic strain rate (1.39±0.57 versus 1.18±0.65; P=0.045) and systolic radial velocity (37.40±17.22 versus 32.88±13.58; P=0.038). Increased T2, as well as lower cardiac index, and defined abnormal strain parameters on room air were predictive for hyperoxia‐induced abnormalities (P<0.05). Furthermore, in patients with prolonged native T1 (>1220 ms), hyperoxia reduced ejection fraction and peak strain. Conclusions Patients with CAD and pre‐existent myocardial injury who respond to hyperoxic challenge with strain abnormalities appear susceptible for hyperoxia‐induced regional deoxygenation and deterioration of myocardial function. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02233634. |
| first_indexed | 2024-12-13T08:58:21Z |
| format | Article |
| id | doaj.art-115400b07f944117ac350efa3353ad8c |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T08:58:21Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-115400b07f944117ac350efa3353ad8c2022-12-21T23:53:12ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-03-019510.1161/JAHA.119.014739Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery DiseaseDominik P. Guensch0Kady Fischer1Kyohei Yamaji2Silvia Luescher3Yasushi Ueki4Bernd Jung5Gabor Erdoes6Christoph Gräni7Hendrik von Tengg‐Kobligk8Lorenz Räber9Balthasar Eberle10Department of Anaesthesiology and Pain Medicine Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Anaesthesiology and Pain Medicine Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Cardiology Inselspital University Hospital Bern University of Bern SwitzerlandDepartment of Anaesthesiology and Pain Medicine Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Cardiology Inselspital University Hospital Bern University of Bern SwitzerlandDepartment of Diagnostic, Interventional and Paediatric Radiology Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Anaesthesiology and Pain Medicine Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Cardiology Inselspital University Hospital Bern University of Bern SwitzerlandDepartment of Diagnostic, Interventional and Paediatric Radiology Inselspital Bern University Hospital University of Bern SwitzerlandDepartment of Cardiology Inselspital University Hospital Bern University of Bern SwitzerlandDepartment of Anaesthesiology and Pain Medicine Inselspital Bern University Hospital University of Bern SwitzerlandBackground The impact of hyperoxia, that is, supraphysiological arterial partial pressure of O2, on myocardial oxygen balance and function in stable multivessel coronary artery disease (CAD) is poorly understood. In this observational study, we assessed myocardial effects of inhalational hyperoxia in patients with CAD using a comprehensive cardiovascular magnetic resonance exam. Methods and Results Twenty‐five patients with stable CAD underwent a contrast‐free cardiovascular magnetic resonance exam in the interval between their index coronary angiography and subsequent revascularization. The cardiovascular magnetic resonance exam involved T1 and T2 mapping for tissue characterization (fibrosis, edema) as well as function imaging, from which strain analysis was derived, and oxygenation‐sensitive cardiovascular magnetic resonance imaging. The latter modalities were both acquired at room air and after breathing pure O2 by face mask at 10 L/min for 5 minutes. In 14 of the 25 CAD patients (56%), hyperoxia induced poststenotic myocardial deoxygenation with a subsequent oxygenation discordance across the myocardium. Extent of deoxygenation was correlated to degree of stenosis (r=−0.434, P=0.033). Hyperoxia‐associated poststenotic deoxygenation was accompanied by ipsiregional reduction of diastolic strain rate (1.39±0.57 versus 1.18±0.65; P=0.045) and systolic radial velocity (37.40±17.22 versus 32.88±13.58; P=0.038). Increased T2, as well as lower cardiac index, and defined abnormal strain parameters on room air were predictive for hyperoxia‐induced abnormalities (P<0.05). Furthermore, in patients with prolonged native T1 (>1220 ms), hyperoxia reduced ejection fraction and peak strain. Conclusions Patients with CAD and pre‐existent myocardial injury who respond to hyperoxic challenge with strain abnormalities appear susceptible for hyperoxia‐induced regional deoxygenation and deterioration of myocardial function. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02233634.https://www.ahajournals.org/doi/10.1161/JAHA.119.014739blood‐oxygen level dependencecoronary artery diseasehyperoxiaoxygenoxygenation‐sensitive cardiovascular magnetic resonance |
| spellingShingle | Dominik P. Guensch Kady Fischer Kyohei Yamaji Silvia Luescher Yasushi Ueki Bernd Jung Gabor Erdoes Christoph Gräni Hendrik von Tengg‐Kobligk Lorenz Räber Balthasar Eberle Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease blood‐oxygen level dependence coronary artery disease hyperoxia oxygen oxygenation‐sensitive cardiovascular magnetic resonance |
| title | Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease |
| title_full | Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease |
| title_fullStr | Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease |
| title_full_unstemmed | Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease |
| title_short | Effect of Hyperoxia on Myocardial Oxygenation and Function in Patients With Stable Multivessel Coronary Artery Disease |
| title_sort | effect of hyperoxia on myocardial oxygenation and function in patients with stable multivessel coronary artery disease |
| topic | blood‐oxygen level dependence coronary artery disease hyperoxia oxygen oxygenation‐sensitive cardiovascular magnetic resonance |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.014739 |
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