Analysis of Acute and Chronic Heart Failure in View of Hepatic Oxygen Supply-Demand Relationship Using Hepatic Venous Oxygen Saturation : SYMPOSIUM ON PATHOPHYSIOLOGY AND SEVERITY OF HEART FAILURE IN THE ASPECT OF CIRCULATORY INSUFFICIENCY

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The adequacy of hepatic circulation in terms of oxygen supply-demand relation was assessed by measuring hepatic venous oxygen saturation (Shvo_2) in patients. Among those with congenital cardiac lesions (n=11),, Shvo_2 during the early postoperative period was markedly low as less than 20% in Fontan operation group (n=5) with subsequent clinical findings of acute hepatic dysfunction. Significant correlations were found between Shvo_2 values early after surgery and subsequent peak values in serum hepatic enzymes. Serum total bilirubin and prothrombin time started to deteriorate when Shvo_2 became below 30%. Cardiac index, hepatic perfusion pressure and mixed venous oxygen saturation showed positive linear correlations with Shvo_2, and central venous pressure (CVP) with an inverse relation. In chronic valvular disease 8n-28), those with NYHA class IV patients showed lower Shvo_2 (average; 47.4%) at cardiac catheterization than the others (class-I; 66.4%, class-II; 63.9%, p<0.05). These results indicate that Shvo_2 monitoring appears to be useful to assess the hepatic perfusion in terms of oxygen supply-demand relation in acute and chronic heart failure, and Shvo_2 of 30% seems to be a critical level.
社団法人日本循環器学会の論文
1989-02-20