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Cardiovascular Disease |

Can Early Changes in Cerebral Oxygenation During Submaximal Exercise Predict Outcomes in Heart Failure Patients?

Luay Rifai*, MD; Kemisha Key, MD; Winna Taylor, MD; Marc Silver, MD
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University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, IL


Chest. 2012;142(4_MeetingAbstracts):82A. doi:10.1378/chest.1389691
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Abstract

SESSION TYPE: Heart Failure

PRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AM

PURPOSE: Resting cerebral oximetry (SctO2) monitoring in heart failure (HF) pts is a novel, non-invasive method of describing target organ perfusion and correlates with several important HF biomarkers. Similarly, cardiopulmonary exercise (CPX) testing in HF pts describes functional capacity and prognosis via several maximal and submaximal measurements. In an attempt to further understand the role of SctO2 monitoring, we examined whether SctO2 at anaerobic threshold (AT) correlated with submaximal and maximal exercise variables.

METHODS: Twenty-seven pts who had Stage C HF underwent a symptom-limited CPX test. Oxygen consumption data at AT and peak exercise (PK) was recorded on all pts. Bilateral SctO2 was monitored continuously utilizing near-infrared spectroscopy (FORE-SIGHT®, CASMED, Branford, CT). We correlated the decline in SctO2 from rest to AT with known prognostic markers, including exercise time, peakVO2, peakVO2/HR and VE/VCO2 slope at both AT and PK.

RESULTS: The mean SctO2 values were 62.6±8.5% (range, 42.9 to 76.2%), 59.9±9.6% (range, 38 to 74%) at rest and AT, respectively. During exercise, the average decline in SctO2 from rest to AT was 2.7±3.2% (range, -2.2 to 10.2%). There was a moderate positive trend between SctO2 at AT and exercise time, peak VO2 and VO2/HR at PK. There was a significant correlation between SctO2 at AT and both, VO2 at AT and VO2/HR at AT (P<0.05). Additionally, the difference in SctO2 (rest-AT) was significantly related to VO2 at AT, but not with peak VO2.

CONCLUSIONS: In pts with symptomatic HF undergoing CPX, we observed important relationships both between SctO2 at AT as well as the decline in SctO2 from rest-AT and multiple other submaximal and peak exercise prognostic markers. These data underscore the value of SctO2 monitoring in HF pts both at rest and with exercise.

CLINICAL IMPLICATIONS: Submaximal exercise SctO2 monitoring provides information on the status and prognosis of HF pts and may prove to be a useful and economic surrogate addition for traditional CPX.

DISCLOSURE: The following authors have nothing to disclose: Luay Rifai, Kemisha Key, Winna Taylor, Marc Silver

No Product/Research Disclosure Information

University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, IL

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