冠状动脉疾病患者中CO再呼吸法的安全性。

Safety of the CO-Rebreathing Method in Patients with Coronary Artery Disease.

作者信息

Karlsen Trine, Leinan Ingeborg Megård, Aamot Inger-Lise, Dalen Håvard, Støylen Asbjørn

机构信息

1K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, NORWAY; 2Department of Cardiology, St. Olav's University Hospital, NORWAY; 3Clinical Services, St. Olav's University Hospital, NORWAY; 4Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Norway; and 5Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, NORWAY.

出版信息

Med Sci Sports Exerc. 2016 Jan;48(1):33-8. doi: 10.1249/MSS.0000000000000729.

DOI:10.1249/MSS.0000000000000729

PMID:26672919

Abstract

PURPOSE

To address and study the safety concerns with the improved carbon monoxide (CO) rebreathing method for measuring total blood volume in patients with coronary artery disease to implement the use of the methodology in this patient group.

METHODS

Eighteen patients with stable coronary artery disease (age 62 ± 7 yr, 24 ± 5 months since diagnosis) were investigated using the improved CO-rebreathing test. Before, during, and up to 2 h after the test, ECG, blood pressure, arterial oxygen saturation, carbon monoxide bound to hemoglobin (HbCO%), and cardiac function were measured. At 24 h, HbCO% and troponin-T were measured.

DESIGN

Cross-over.

RESULTS

Six minutes after the CO-rebreathing test, HbCO increased from 1.5% ± 0.4% to 6.0% ± 0.6%, with a subsequent decrease to 4.5% ± 0.4% and 1.4% ± 0.4% at 2 h and 24 h after the test, respectively. Resting heart rate, stroke volume, cardiac output, and ejection fraction were 64 ± 11 bpm, 93.9 ± 16.5 mL per beat, 5.84 ± 0.99 L, and 48.5% ± 5.7% and remained unchanged during and 10 min after the rebreathing. All patients were in sinus rhythm during the 2-h observation period, without ST- or T-wave changes, with low numbers of premature beats and normal rate variability. Systolic and diastolic blood pressure gradually decreased during the observation period. Troponin-T was below the 99th percentile for all the participants 24 h after the test.

CONCLUSION

Cardiovascular function and safety indices remained unchanged after exposure to approximately 6% HbCO, indicating that the method is safe to perform in patients with stable coronary artery disease.

摘要

目的

探讨并研究改良一氧化碳（CO）重呼吸法测量冠心病患者总血容量时的安全性问题，以便在该患者群体中应用此方法。

方法

采用改良的CO重呼吸试验对18例稳定型冠心病患者（年龄62±7岁，诊断后24±5个月）进行研究。在试验前、试验期间及试验后2小时内，测量心电图、血压、动脉血氧饱和度、碳氧血红蛋白（HbCO%）及心功能。在24小时时，测量HbCO%及肌钙蛋白-T。

设计

交叉试验。

结果

CO重呼吸试验6分钟后，HbCO从1.5%±0.4%升至6.0%±0.6%，随后在试验后2小时及24小时分别降至4.5%±0.4%和1.4%±0.4%。静息心率、每搏输出量、心输出量及射血分数分别为64±11次/分钟、每搏93.9±16.5毫升、5.84±0.99升及48.5%±5.7%，在重呼吸期间及重呼吸后10分钟保持不变。在2小时观察期内，所有患者均为窦性心律，无ST段或T波改变，早搏数量少，心率变异性正常。观察期内收缩压和舒张压逐渐下降。试验后24小时，所有参与者的肌钙蛋白-T均低于第99百分位数。