Cerebral Oxygenation During Exercise in Cardiac Patients

Koike, Atsushi; Itoh, Hidenori; Oohara, Reiko; Hoshimoto, Masayo; Tajima, Akihiko; Aizawa, Tadanori; Fu, Long Tai

doi:10.1378/chest.125.1.182

Cited by 80 publications

(85 citation statements)

References 34 publications

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“…It is assumed that a higher _ VE/ _ VCO 2 slope leads to a worse prognosis by these mechanisms determining the _ VE/ _ VCO 2 slope. It has been reported that the values of PETCO 2 at rest and at peak exercise are, on average, 34 and 40 mmHg, respectively, in healthy subjects of approximately 60 years of age [19]. Thus, PETCO 2 at rest and at peak exercise in non-survivors of the present study are considerably lower than those reported in healthy subjects.…”

Section: Parameters Obtained From Cardiopulmonary Exercise Testingcontrasting

confidence: 64%

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

et al. 2008

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We compared the prognostic power of end-tidal CO 2 pressure (PETCO 2 ) during exercise, an index of arterial CO 2 pressure, with those of established respiratory gas indexes during exercise testing in patients with left ventricular dysfunction. Seventy-eight consecutive patients with a left ventricular ejection fraction (LVEF) B40% were enrolled in the study. All the patients performed a symptom-limited incremental exercise test with respiratory gas measurements. PETCO 2 at peak exercise, peak O 2 uptake ( _ VO 2 ), the ratio of the increase in ventilation to the increase in CO 2 output ( _ VE/ _ VCO 2 slope), and the ratio of the increase in _ VO 2 to the increase in work rate (D _ VO 2 / DWR) were measured. PETCO 2 at peak exercise was significantly correlated with peak _ VO 2 , _ VE/ _ VCO 2 slope and D _ VO 2 /DWR. During a prospective follow-up period of 992 ± 570 days, 14 cardiac deaths occurred. As compared to survivors, non-survivors had a significantly lower LVEF, lower PETCO 2 at peak exercise, lower peak _ VO 2 , lower D _ VO 2 /DWR and a higher _ VE/ _ VCO 2 slope. Among these indexes, only PETCO 2 at peak exercise was found to be an independent predictor for cardiac death. PETCO 2 at peak exercise is useful in predicting poor prognosis in patients with left ventricular systolic dysfunction.

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Section: Parameters Obtained From Cardiopulmonary Exercise Testingcontrasting

confidence: 64%

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

et al. 2008

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“…11 PETO2 at rest and at peak exercise was 111.2 and 112.3 mmHg, respectively, in these subjects. 11 Thus, it appears that PETCO2 at peak exercise was low and PETO2 at peak exercise was high in the present patients, as compared to that reported in healthy subjects, although no difference was observed in the values obtained at rest (the means of the healthy subjects are shown in vertical lines in Figures 2-5).…”

Section: Discussionsupporting

confidence: 49%

“…11 In the latter study, PETO2 and PETCO2 both at rest and at peak exercise (but not at AT) were measured in healthy subjects with similar age (60.3±8.3 years) using the same respiratory gas analyzer (Aeromonitor AE-300S). PETCO2 at rest and at peak exercise was, on average, 33.5 and 39.8 mmHg, respectively, in these healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Abnormal End-Tidal PO2 and PCO2 at the Anaerobic Threshold Correlate Well With Impaired Exercise Gas Exchange in Patients With Left Ventricular Dysfunction

Kuwabara

Koike

Hoshimoto-Iwamoto

et al. 2012

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp n resting normal subjects at sealevel, alveolar PO2 and PCO2 are approximately 100 mmHg and 40 mmHg, respectively. In patients with pulmonary vascular occlusive disease, there is regional hypoperfusion relative to ventilation. This is reflected in an increased physiological dead space ventilation, due to an uneven ventilation -perfusion (V/Q) relationship, that is, high V/Q mismatch. Consequently, endtidal PCO2 (PETCO2) is reduced and end-tidal PO2 (PETO2) is increased. 1 Patients with left ventricular (LV) dysfunction also have high V/Q mismatch because of reduced pulmonary blood flow despite adequate ventilation. 2,3 Thus, in these patients, PETO2 must be higher and PETCO2 must be lower, according to the severity of LV dysfunction.In the present study, we hypothesized that in patients with LV dysfunction, PETO2 and PETCO2 measured during exercise may be better correlated with the severity of the cardiopulmonary dysfunction than that at rest. In order to test this hypothesis, we measured PETCO2 and PETO2 both at rest, at anaerobic threshold (AT) and at peak exercise. We then correlated these variables with indices of cardiopulmonary function during exercise, 4 in patients with LV dysfunction. Methods SubjectsThe subjects were 38 consecutive cardiac patients who performed exercise testing with respiratory gas analysis at the Cardiovascular Institute between January 2007 and December Background: The aim of the present study was to compare the end-tidal O2 pressure (PETO2) to end-tidal CO2 pressure (PETCO2) in cardiac patients during rest and during 2 states of exercise: at anaerobic threshold (AT) and at peak. The purpose was to see which metabolic state, PETO2 or PETCO2, best correlated with exercise limitation. I

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“…However, this may not be the case in cardiac patients with left ventricular (LV) dysfunction. 3,4 Our group recently studied cerebral oxygenation during exercise in patients with dilated cardiomyopathy 3 using near-infrared spectroscopy (NIRS) to continuously measure the change in cerebral oxyhemoglobin (O2Hb) during exercise. As a result, we found that nearly 50% of the patients exhibited decreases in cerebral O2Hb during exercise, and the rate was even higher among those with lower LV ejection fraction (LVEF).…”

mentioning

confidence: 99%

Effects of Supplemental O2 Inhalation on Cerebral Oxygenation During Exercise in Patients With Left Ventricular Dysfunction

Koike

Nagayama

Goda

et al. 2007

Circ J

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Cerebral Oxygenation During Exercise in Cardiac Patients

Cited by 80 publications

References 34 publications

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

Prognostic value of end-tidal CO2 pressure during exercise in patients with left ventricular dysfunction

Abnormal End-Tidal PO2 and PCO2 at the Anaerobic Threshold Correlate Well With Impaired Exercise Gas Exchange in Patients With Left Ventricular Dysfunction

Effects of Supplemental O2 Inhalation on Cerebral Oxygenation During Exercise in Patients With Left Ventricular Dysfunction

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