Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.
Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan.
Adv Exp Med Biol. 2024;1463:323-327. doi: 10.1007/978-3-031-67458-7_52.
Oxygenated haemoglobin (OHb) and total haemoglobin (THb) concentrations rise with increasing exercise load during the cardiopulmonary exercise test (CPX); however, this elevated response is impaired in patients with chronic heart failure. Furthermore, the changes occurring in patients during the acute phase of cardiac surgery are unknown. This study aimed to measure cerebral oxygenation in the prefrontal cortex (PFC) during CPX in patients during the acute post-operative phase following cardiovascular surgery. Fourteen patients in the acute phase of post-cardiovascular surgery period were enrolled. CPX was administered between the post-operative period and discharge. The protocol employed the ramp method (10 W/min) after 3-min rest and 3-min warm-up periods. Levels of OHb, deoxygenated haemoglobin (HHb), THb, and the regional cerebral oxygen saturation (rSO) in the PFC were measured from the resting state through the end of CPX using near-infrared spectroscopy. The mean values of OHb, HHb, and THb levels and rSO were compared at rest, warm-up, anaerobic threshold, and peak points. At the peak, OHb and rSO declined significantly, and HHb rose significantly compared to the respective values at rest; no significant changes were observed in THb. These findings suggest that the oxygen supply to the PFC is reduced in patients with reduced cardiac function following cardiovascular surgery.
在心肺运动测试（CPX）中，随着运动负荷的增加，氧合血红蛋白（OHb）和总血红蛋白（THb）浓度升高；然而，这种升高的反应在慢性心力衰竭患者中受损。此外，心脏手术急性阶段患者的变化尚不清楚。本研究旨在测量心血管手术后急性阶段患者 CPX 期间前额叶皮层（PFC）的脑氧合。纳入了 14 名心血管手术后急性阶段的患者。CPX 在术后期间至出院期间进行。该方案在 3 分钟休息和 3 分钟热身期后采用斜坡法（10 W/min）。使用近红外光谱法，从休息状态到 CPX 结束，测量 PFC 中的 OHb、去氧血红蛋白（HHb）、THb 和局部脑氧饱和度（rSO）水平。比较了休息、热身、无氧阈和峰值时 OHb、HHb 和 THb 水平和 rSO 的平均值。在峰值时，与休息时相比，OHb 和 rSO 显著下降，HHb 显著升高；THb 无明显变化。这些发现表明，在心血管手术后心脏功能降低的患者中，PFC 的氧供应减少。
