Changes in Cerebral Oxygenation in the Prefrontal Cortex During Cardiopulmonary Exercise Testing in Patients After Cardiovascular Surgery

Oxygenated haemoglobin (O2Hb) and total haemoglobin (THb) concentrations rise with increasing exercise load during the cardiopulmonary exercise test (CPX); however, this elevated response is impaired in patients with chronic heart failure. Furthermore, the changes occurring in patients during the acute phase of cardiac surgery are unknown. This study aimed to measure cerebral oxygenation in the prefrontal cortex (PFC) during CPX in patients during the acute post-operative phase following cardiovascular surgery. Fourteen patients in the acute phase of post-cardiovascular surgery period were enrolled. CPX was administered between the post-operative period and discharge. The protocol employed the ramp method (10 W/min) after 3-min rest and 3-min warm-up periods. Levels of O2Hb, deoxygenated haemoglobin (HHb), THb, and the regional cerebral oxygen saturation (rSO2) in the PFC were measured from the resting state through the end of CPX using near-infrared spectroscopy. The mean values of O2Hb, HHb, and THb levels and rSO2 were compared at rest, warm-up, anaerobic threshold, and peak points. At the peak, O2Hb and rSO2 declined significantly, and HHb rose significantly compared to the respective values at rest; no significant changes were observed in THb. These findings suggest that the oxygen supply to the PFC is reduced in patients with reduced cardiac function following cardiovascular surgery.