The relationship between mixed venous blood oxygen saturation and pulmonary arterial and venous pressures in patients with heart failure.

Autor: Funaki R; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Ogawa K; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Mashitani Y; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Oh T; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Kashiwagi Y; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Tanaka TD; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Nagoshi T; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Kawai M; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Yoshimura M; Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Physiological reports [Physiol Rep] 2024 Nov; Vol. 12 (22), pp. e70128.
DOI: 10.14814/phy2.70128
Abstrakt: Recent discoveries have identified intrapulmonary bronchopulmonary anastomoses (IBAs) as a relatively common phenomenon forming intrapulmonary right-to-left shunts. This study hypothesizes that IBAs play a significant role in the pathophysiology of heart failure. We aim to investigate the impact of these intrapulmonary right-to-left shunts on pulmonary arterial and venous pressures in heart failure patients, utilizing mixed venous oxygen saturation (SvO₂) as a key measurement. This study included 237 patients with heart failure who underwent cardiac catheterization. The relationships between SvO₂ and pulmonary artery systolic pressure (sPAP), pulmonary artery wedge pressure (PAWP), and left ventricular end-diastolic pressure (LVEDP) were examined using various statistical methods (single regression analysis, partial correlation analysis, structural equation modeling, and Bayesian estimation). All statistical methods that we performed showed that SvO₂ was significantly and negatively correlated with both sPAP and PAWP (p < 0.01, respectively). However, SvO₂ did not significantly correlate with LVEDP. These results suggest that a decrease in SvO₂ leads to an increase in PAWP and sPAP, while LVEDP is only passively influenced by PAWP. This phenomenon likely reflects the impact of an intrapulmonary right-to-left shunt caused by IBAs. The decrease in SvO₂ causes an increase in sPAP and may also cause an increase in PAWP via IBAs.
(© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)
Databáze: MEDLINE
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