Effects of supplemental O2 inhalation on cerebral oxygenation during exercise in patients with left ventricular dysfunction.

Background: It has been recently reported that cerebral oxyhemoglobin (O(2)Hb) decreases during exercise in nearly 50% of patients with dilated cardiomyopathy. The present study evaluated whether the inhalation of supplemental O(2) diminishes the decrease in cerebral O(2)Hb during exercise.

Methods And Results: Ten patients with a left ventricular ejection fraction <50% and a clearly observable decrease in cerebral O(2)Hb during preliminary exercise testing underwent 2 additional symptom-limited incremental exercise tests: 1 while breathing room air (control) and the other while breathing 50% O(2). In the latter test, the switch from room air to 50% O(2) was performed, on average, at 43.0+/-14.2 W. Cerebral O(2)Hb was continuously monitored during exercise using near-infrared spectroscopy. In the control exercise test, cerebral O(2)Hb gradually decreased as the work rate increased in all the subjects. When the subjects breathed 50% O(2), this decrease in cerebral O(2)Hb was diminished. The change in cerebral O(2)Hb from rest to peak exercise during the test under 50% O(2) was significantly higher than that during the control test (-0.23 +/-1.89 vs -2.47+/-1.57 micromol/L, p=0.002). Similarly, the change in the cerebral tissue oxygenation index was significantly higher in the test under 50% O(2) (0.45 +/-4.46 vs -3.33+/-3.06%, p=0.023).

Conclusions: Impaired cerebral oxygenation during moderate to heavy intensity exercise in patients with left ventricular dysfunction can be offset by breathing supplemental O(2).