Baseline regional cerebral oxygen saturation correlates with left ventricular systolic and diastolic function

To evaluate the correlation between baseline cerebral oxygen saturation (ScO(2)) and cardiac function as assessed by pulmonary artery catheterization and transesophageal echocardiography (TEE).

A retrospective study.

A tertiary care university hospital.

Cardiac surgery patients.

Patients undergoing cardiac surgery with bilateral recording of their baseline ScO(2) using the INVOS 4100 (Somanetics, Troy, MI) were selected. A pulmonary artery catheter was used to obtain their hemodynamic profile. Left ventricular (LV) systolic and diastolic function was evaluated by TEE, after the induction of anesthesia, using standard criteria. A model was developed to predict ScO(2). A total of 99 patients met the inclusion criteria. There were significant correlations between mean ScO(2) values and central venous pressure (CVP) (r = -0.31, p = 0.0022), pulmonary capillary wedge pressure (r = -0.25, p = 0.0129), mean pulmonary artery pressure (MPAP) (r = -0.24, p = 0.0186), mean arterial pressure/MPAP ratio (r = 0.33, p = 0.0011), LV fractional area change (<35, 35-50, and >or=50, p = 0.0002), regional wall motion score index (r = -0.27, p = 0.0062), and diastolic function (p = 0.0060). The mean ScO(2) had the highest area under the receiver operating characteristic curve (0.74; confidence interval, 0.64-0.84) to identify LV systolic dysfunction. A model predicting baseline ScO(2) was created based on LV systolic echocardiographic variables, CVP, sex, mitral valve surgery, and the use of beta-blocker (r(2) = 0.42, p < 0.001).

Baseline ScO(2) values are related to cardiac function and are superior to hemodynamic parameters at predicting LV dysfunction.