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[Peripheral oxygenation and perfusion in patients with chronic ischemic heart disease complicated by left-ventricular
Insights
Coronary heart disease (CHD) patients without heart failure typically have normal oxygen levels. However, left ventricular failure in CHD patients leads to significant arterial hypoxemia and tissue hypoxia, impacting peripheral circulation.
Area of Science:
- Cardiology
- Physiology
Context:
- Coronary heart disease (CHD) involves diffuse atherosclerosis and postinfarction cardiosclerosis.
- Assessing tissue oxygenation is crucial for understanding heart failure progression.
Purpose:
- To investigate oxygen tension and peripheral circulation in coronary heart disease (CHD) patients with and without heart failure.
Summary:
- In CHD patients without significant heart insufficiency, forearm oxygen tension was generally normal.
- Left ventricular failure in CHD consistently caused arterial hypoxemia and tissue hypoxia, correlating with failure severity.
- Isolated left ventricular failure revealed abnormal peripheral circulation and tissue perfusion, including reduced venous distensibility and blood flow velocity.
Impact:
- Highlights the critical role of left ventricular function in maintaining tissue oxygenation in CHD.
- Demonstrates significant peripheral circulatory abnormalities in CHD patients with left ventricular failure.
- Provides insights into the pathophysiology of impaired tissue perfusion in advanced CHD.
Abstract:
Examination of 33 normal subjects and 91 patients with coronary heart disease (CHD) ascertained that during CHD (diffuse atherosclerotic and postinfarction cardiosclerosis) without clinically marked heart insufficiency, oxygen tension in the arterialized capillary blood and subcutaneous fat of the forearm was normal in the overwhelming majority of cases. Only some of the patients manifested negligible arterial hypoxemia and/or tissue hypoxia. Left ventricular failure was always accompanied by arterial hypoxemia and tissue hypoxia the degree of which was proportional to the gravity of heart insufficiency. In isolated left ventricular failure without congestion in the greater circulation, CHD patients demonstrated abnormal peripheral circulation and tissue perfusion. In particular, the distensibility of the forearm veins was decreased by 43-50%, their capacity was reduced by 28-43%, and the volumetric velocity of the peripheral blood flow in this area was lessened by 34-58%.