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Utility of Continuous Measurement of Pulmonary Artery Oxygen Saturation During Episodic Myocardial Ischemia in Patients

Utility of Continuous Measurement of Pulmonary Artery Oxygen Saturation During Episodic... The use of continuously monitored pulmonary artery oxygen saturation (PAOS)for the assessment of transient myocardial ischemia was examined in a controlled human model during coronary angioplasty, producing brief reversible episodes of myocardial ischemia. Clinical and anatomic variables were prospectively recorded and correlated with changes in continuous PAOS during repeated episodes of coronary artery occulsion. Forty‐seven patients underwent left anterior descending (LAD, n = 43) or circumflex (n = 4) coronary balloon occlusion. Patients were subgrouped by PAOS responses: group 1, 22 patients with ± 10% drop in PAOS during balloon inflation and group 2, 25 patients in whom the PAOS signal was stable or only minimally affected during transient ischemia. Anatomical features analyzed included normal coronary diameter, location of lesion (e.g., proximal to the first septal branch) and extent of myocardium supplied by an occluded artery (LAD extending beyond the apex of the left ventricle (LV) or a large diagonal after the occlusion point). Left ventricular wall motion abnormalities, presence of other coronary artery disease, diabetes and hypertension were also analyzed. Groups were similar with respect to age (61 ± 13, 62 ± 10 years), LV ejection fraction, LV score, incidence of hypertension and diabetes or anatomic scores (2.2 ± 1.0, for group 1 vs 2.0 ± 0.9 for group 2), normal angiographic arterial diameter and presence of coronary collateral supply. Although some episodes of myocardial ischemia in electively studied stable patients may be associated with significant reducitons in PAOS, the occurrence or degree of PAOS reduction is not predicted by coronary anatomy, LV function or other clinical variables. Use of PAOS to identify ischemic events in more critically ill patients is potentially useful, but must be assessed individually during the clinical situation. (J Interven Cardiol 1988:1:2) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Utility of Continuous Measurement of Pulmonary Artery Oxygen Saturation During Episodic Myocardial Ischemia in Patients

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References (14)

Publisher
Wiley
Copyright
Copyright © 1988 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.1988.tb00397.x
Publisher site
See Article on Publisher Site

Abstract

The use of continuously monitored pulmonary artery oxygen saturation (PAOS)for the assessment of transient myocardial ischemia was examined in a controlled human model during coronary angioplasty, producing brief reversible episodes of myocardial ischemia. Clinical and anatomic variables were prospectively recorded and correlated with changes in continuous PAOS during repeated episodes of coronary artery occulsion. Forty‐seven patients underwent left anterior descending (LAD, n = 43) or circumflex (n = 4) coronary balloon occlusion. Patients were subgrouped by PAOS responses: group 1, 22 patients with ± 10% drop in PAOS during balloon inflation and group 2, 25 patients in whom the PAOS signal was stable or only minimally affected during transient ischemia. Anatomical features analyzed included normal coronary diameter, location of lesion (e.g., proximal to the first septal branch) and extent of myocardium supplied by an occluded artery (LAD extending beyond the apex of the left ventricle (LV) or a large diagonal after the occlusion point). Left ventricular wall motion abnormalities, presence of other coronary artery disease, diabetes and hypertension were also analyzed. Groups were similar with respect to age (61 ± 13, 62 ± 10 years), LV ejection fraction, LV score, incidence of hypertension and diabetes or anatomic scores (2.2 ± 1.0, for group 1 vs 2.0 ± 0.9 for group 2), normal angiographic arterial diameter and presence of coronary collateral supply. Although some episodes of myocardial ischemia in electively studied stable patients may be associated with significant reducitons in PAOS, the occurrence or degree of PAOS reduction is not predicted by coronary anatomy, LV function or other clinical variables. Use of PAOS to identify ischemic events in more critically ill patients is potentially useful, but must be assessed individually during the clinical situation. (J Interven Cardiol 1988:1:2)

Journal

Journal of Interventional Cardiology – Wiley

Published: Jun 1, 1988

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