Estimation of myocardial oxygen extraction dynamics in effort angina by continuous measurement of coronary venous saturation Atsushi Mikuniya 1 , Fumitaka Kikuchi 1 , Masato Mikami 1 , Toyohito Narita 1 , Masahisa Takahashi 1 , Mitsuru Satoh 1 , Naohiro Sasaki 1 , Kogo Onodera 1 , Yasaburo Oike 2 1The Second Department of Internal Medicine, Hirosaki University School of Medicine 2Reimeikyo Rehabilitation Hospital Keyword: 労作性狭心症(effort angina) , 心筋酸素摂取(myocardial oxygen extraction) , 冠静脈血中酸素飽和度(coronary venous oxygen saturation) pp.1115-1120
Published Date 1990/11/15
DOI https://doi.org/10.11477/mf.1404910045
  • Abstract
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To estimate myocardial oxygen extraction dynami-cs in the situation of increased myocardial oxygen requirement, we made a continuous measurement of coronary venous oxygen saturation (CSO2-Sat) using the fiberoptic catheter system and a measurement of myocardial lactate extraction ratio (MLER) in 14 patients. Ten patients showed ischemic ST depres-sion and/or anginal episodes during the pacing load-ing, while 4 patients did not. Although transientdecreases in CSO2-Sat were observed in the non-ischemic 4 patients immediately after the initia-tion of pacing or with the increase in pacing rate. CSO2-Sat and MLER remained almost unchanged from the start of pacing to the time of maximal pacing. However, in the 10 patients who developed ischemia, CSO2-Sat fell from 39.5±1.8% before pacing to 32.9±2.8% at the time of maximal pacing (p<0.05), with an average decrease of 6.6±2.8%. Data of MLER obviously indicated the appearance of myocardial ischemia (32.1±4.7% to 9.2±10.3%, p<O.05).

These findings suggest that myocardial oxygen extracton will increase transiently or continuously to meet the myocardial oxygen demand when in-crease in coronary blood flow is limited. Continuous measurement of coronary venous saturation may be useful for the early detection of myocardial ischemia.

Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.


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