Quantitative tissue hemoglobin oxygen saturation measurement in decompensated heart failure

Background

This study determined if patients with acutely decompensated heart failure (HF) have abnormal regional tissue oxygenation when compared with stable outpatients and if values change with treatment.

Methods

We prospectively used differential absorption spectroscopy to measure the subcutaneous tissue hemoglobin oxygen saturation (S_tO₂), both at presentation and discharge in patients admitted with acutely decompensated systolic HF. These values were compared with a convenience sample of stable HF patients to determine if admitted patients have different S_tO₂ values that, after undergoing inpatient treatment, approach those of the stable HF population.

Results

Stable outpatients (n = 45) had significantly higher S_tO₂ values than inpatients (n = 20), both at admission (p < 0.006) and discharge (p < 0.0002). There were no significant differences in the discharge and admission S_tO₂ values. Four inpatients died of HF related causes and 6 were readmitted with HF within 6 months.

Conclusions

Patients with acutely decompensated HF have significantly decreased tissue oxygenation that is lower than those found in the stable outpatient population and does not respond to inpatient treatment. Measurement of subcutaneous tissue hemoglobin oxygen saturation may enable clinicians to diagnose and treat HF more effectively.