Hypoxia and LV dysfunction: Let us learn more from “ COPD, COVID-19 and Tetralogy of Fallot ”

Superficially, tissue hypoxia might look similar to Ischemia but differs in one important aspect. Though the hypoxic myocardium is short of oxygen, the respiratory excreta from cells ie Co2, lactic acid, and free radicles are promptly cleared and flushed as blood flow is normal. Hence, generally acute  Ischemia of tissues is more cell threatening than regional hypoxia at any organ level. How do you classify hypoxia? we need to go to physiology classes again.There are 4 types. Ischemic -Hypoxia, systemic hypoxia, Anemic hypoxia, Histo-toxic hypoxia.A good reference to read (Ošt’ádal B., Kolář F. (1999) Myocardial Hypoxia and Ischemia. In: Cardiac Ischemia: From Injury to Protection. Basic Science for the Cardiologist, vol 4. Springer, Boston, MA.)The question we want to address here is the effect of systemic hypoxia on LV function.We encounter this in different settings.Chronic hypoxia  :In COPD, there can be slow adaptation, still there will be some definite impairment of myocardial function.(Which may not be important in normal times but will tell at times of other stress ) Many studies have documented COPD to compromise LV function. In fact, DCM has a link with some severe forms of COPD (Personal observation, will try to get the evidence )In acute hypoxia(Non-Ischemic) it causes organ dysfunction.(Acute pulmonary embolism, and sepsis.) We see this often in IMCU with ventilated patients with  multisytem defects a poorly contractile ventricles. Some of us used to re...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: metabolic support of heart failure anerobic cardiac metabolism copd and lv dysfunction covid heart disease hypoxia and covid lv dysfunction hypoxia vs iscehmia ketone bodies ato heart lv dysfunction in congenital cyanotic heart disease met Source Type: blogs