Peripheral tissue oxygenation in patients with Coronary artery disease and Heart failure; a near-infrared spectroscopy study
A Ntalianis, C Kourek, G Velissaris, N Papaioannou, K Mpirmpilis, D Chatzis, N Biagkis, E Karatzanos, S Gyftopoulos, K Papadopoulos, M Zagkli, S Tomaras, V Stavropoulou, S Papaioannou, K BratisAbstract
Background
Coronary artery disease and heart failure are both associated with dysregulation of peripheral tissue oxygenation and coronary microcirculatory dysfunction.
Purpose
We investigated functional differences in peripheral microcirculation and tissue oxygenation of: a) healthy volunteers (Controls), b) patients with coronary artery disease (CAD) and c) patients with heart failure (HF).
Methods
Near-infrared spectroscopy was applied in 67 individuals [16 Controls, 29 consecutive patients with CAD and 22 consecutive patients with HF and impaired left ventricular ejection fraction (<50%)] . The following 4 parameters were determined with NIRS: a) the baseline tissue oxygenation (STO2) b) the occlusion slope [the rate of tissue desaturation after occlusion (Occl slope)], c) the recovery slope (the slope of the hyperemic tissue oxygenation pattern after occlusion (Rec slope), d) the time of hyperemic tissue oxygenation after occlusion (Timehyper).
Results
Except from age which was lower in the Controls, the basic clinical characteristics were similar among the 3 groups. Patients with HF were in higher NYHA status (2.86±0.8 vs 1.17±0.4 in CAD vs 1±0.3 in Controls) and had higher NT-proBNP levels (1540±1710 pg/dL vs 241±194 in CAD vs 49±11 in Controls, p=0.003). A positive correlation of the NT-proBNP and Occl slope was found (r=0.41, p=0.013, Figure 1). A lower Rec Slope was found in patients with CAD (3.79±0.7 vs 4.96±0.7 in HF vs 5.3±1.5 in Controls, p=0.001) and a trend for higher Time hyper in the CAD group was observed (154±30 vs 137±30 in HF vs 132±32 sec in Controls, p=0.067, Figure 2).
Conclusions
Impaired peripheral tissue oxygenation and microcirculatory dysfunction is more prominent in patients with coronary artery disease.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.