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Hemoglobin affinity for oxygen in coronary sinus blood during rapid atrial pacing and supine bicycle ergometer exercise testings in patients with coronary artery disease Takashi Miyahara 1 , Mitsuhiro Yokota 1 , Susumu Kamihara 1 , Atsushi Tsunekawa 1 , Masabumi Koide 1 , Kazunobu Yamauchi 1 , Hiroshi Hayashi 1 , Iwao Sotobata 2 1Cardiology Sectlon, the First Department of Internal Medicine, Nagoya University, School of Medicine 2Department of Internal Medicine, Fujita-Gakuen Health University School pp.681-685
Published Date 1988/6/15
DOI https://doi.org/10.11477/mf.1404205279
  • Abstract
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The purpose of this study was to evaluate whether P50 (the partial pressure of oxygen at which 50% of hemoglobin is saturated with oxygen) levels in coronary sinus blood (CSB) can be a useful index to predict acute myocardial ischemia and can reflect left ventricular function during rapid atrial pacing (APc) and supine bicycle ergometer exercise (BEX) testings in patients with coronary artery disease(CAD). The subjects consisted of 12 patients (mean-age 54 yrs ; range 46-66 yrs) with CAD. Peak APc rate was set at 85% of maximal predicted HR, and BEX was performed up to the appearance of sym-ptoms such as angina. An anginal attack was indu-ced in 4 patients during both APc and BEX. CSB was sampled for the measurement of P50 and 2,3- DPG concentrations and pH before and immediately after APc and BEX. An influence of angina on cha-nges in P50 levels in CSB was evaluated, and P50 levels in CSB were compared with hemodynamic parameters such as cardiac index before and imme-diately BEX and with exercise time. APc produced no significant change in P50 levels in CSB. Of 4 patients with APc-induced angina, 2 had an increase in P50 levels in CSB, and 2 had a decrease in Pso levels in CSB. BEX produced a significant increase in Pso levels in CSB. This phenomenon might be explained by the Both effect. Three of 4 patients with exercise-induced angina also had an increase in P50 levels in CSB, which was not considered a specific change for patients with BEX-induced angina. P50 levels in CSB at rest had no significant correla-tion with cardiac index at rest. However, Pso levels in CSB at rest showed a significant negative cor-relation with cardiac index at peak exercise and with exercise time. It was suggested that measurements of P50 levels in CSB cannot be used to predict acute myocardial ischemia, but that P50 levels in CSB at rest might reflect left ventricular function during dynamic leg exercise and could be a useful parameter to estimate cardiac reserve.


Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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