The Impact of Oxygen Pulse and Its Curve Patterns on Male Patients with Heart Failure, Chronic Obstructive Pulmonary Disease, and Healthy Controls-Ejection Fractions, Related Factors and Outcomes

Ming-Lung Chuang; Chin-Feng Tsai; Kwo-Chang Ueng; Jui-Hung Weng; Ming-Fong Tsai; Chien-Hsien Lo; Gang-Bin Chen; Sung-Kien Sia; Yao-Tsung Chuang; Tzu-Chin Wu; Pan-Fu Kao; Meng-Jer Hsieh

doi:10.3390/jpm12050703

The Impact of Oxygen Pulse and Its Curve Patterns on Male Patients with Heart Failure, Chronic Obstructive Pulmonary Disease, and Healthy Controls-Ejection Fractions, Related Factors and Outcomes

J Pers Med. 2022 Apr 28;12(5):703. doi: 10.3390/jpm12050703.

Authors

Ming-Lung Chuang^{1

2}, Chin-Feng Tsai^{2

3}, Kwo-Chang Ueng^{2

3}, Jui-Hung Weng^{2

4}, Ming-Fong Tsai⁵, Chien-Hsien Lo^{3

6}, Gang-Bin Chen¹, Sung-Kien Sia^{2

3}, Yao-Tsung Chuang^{2

3}, Tzu-Chin Wu¹, Pan-Fu Kao^{2

4}, Meng-Jer Hsieh^{7

8}

Affiliations

¹ Division of Pulmonary Medicine and Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
² School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
³ Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
⁴ Department of Nuclear Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
⁵ Department of Nuclear Medicine, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Chiayi 61301, Taiwan.
⁶ Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
⁷ Department of Respiratory Therapy, Chang Gung University, Taoyuan 33303, Taiwan.
⁸ Department of Pulmonary and Critical Care Medicine, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Chiayi 61301, Taiwan.

Abstract

Oxygen pulse (O₂P) is a function of stroke volume and cellular oxygen extraction and O₂P curve pattern (O₂PCP) can provide continuous measurements of O₂P. However, measurements of these two components are difficult during incremental maximum exercise. As cardiac function is evaluated using ejection fraction (EF) according to the guidelines and EF can be obtained using first-pass radionuclide ventriculography, the aim of this study was to investigate associations of O₂P%predicted and O₂PCP with EF in patients with heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) and chronic obstructive pulmonary disease (COPD), and also in normal controls. This was a prospective observational cross-sectional study. Correlations of resting left ventricular EF, dynamic right and left ventricular EFs and outcomes with O₂P% and O₂PCP across the three participant groups were analyzed. A total of 237 male subjects were screened and 90 were enrolled (27 with HFrEF/HFmrEF, 30 with COPD and 33 normal controls). O₂P% and the proportions of the three types of O₂PCP were similar across the three groups. O₂P% reflected dynamic right and left ventricular EFs in the control and HFrEF/HFmrEF groups, but did not reflect resting left ventricular EF in all participants. O₂PCP did not reflect resting or dynamic ventricular EFs in any of the subjects. A decrease in O₂PCP was significantly related to nonfatal cardiac events in the HFrEF/HFmrEF group (log rank test, p = 0.01), whereas O₂P% and O₂PCP did not predict severe acute exacerbations of COPD. The findings of this study may clarify the utility of O₂P and O₂PCP, and may contribute to the currently used interpretation algorithm and the strategy for managing patients, especially those with HFrEF/HFmrEF. (Trial registration number NCT05189301.).

Keywords: chronic obstructive pulmonary disease; ejection fraction; exercise testing; heart failure with reduced or mildly reduced ejection fraction.

Associated data

ClinicalTrials.gov/NCT05189301

Grants and funding

This study received grants from the Ministry of Science and Technology of Taiwan (MOST 106-2314-B-040-025) and Chung Shan Medical University Hospital (CSH-2019-C-030). The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. None funding support was declared within the funding program Open Access Publishing.