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The application of partial pressure of oxygen adjusted indirect Fick method in vasoreactivity testing by inhaling oxygen in congenital heart disease

Hypertension Research (2025)Cite this article

Abstract

The influence of partial pressure of oxygen (pO2) is often overlooked during vasoreactivity testing by inhaling oxygen in congenital heart diseases (CHD). This study aims to evaluate the influence of pO2 on hemodynamic data. Patients with simple CHDs and suspected pulmonary arterial hypertension undergoing right heart catheterization including vasoreactivity testing by inhaling O2 were consecutively enrolled from June 2023 to March 2025. Patients with an arterial O2 saturation below 98% after inhaling O2 were excluded. Cardiac output was calculated using indirect Fick method, where blood O2 content (1.39 × hemoglobin × O2 saturation + 0.032 × pO2) was excluded (unadjusted) or included (adjusted) with the pO2 term. Hemodynamic data after inhaling O2 calculated by both methods were compared. An over 20% decrease in pulmonary vascular resistance with stable blood pressure was considered a positive vasoreactivity testing. During the study period, a total of 136 patients with simple CHDs were enrolled and 129 of them were diagnosed with pulmonary arterial hypertension. In vasoreactivity testing, after adjustment, pulmonary / systemic blood flow ratio decreased from 4.32 ± 5.82 to 2.51 ± 1.67, while pulmonary vascular resistance was increased from 5.62 ± 4.18 WU to 7.04 ± 4.44 WU. The response to O2 was adjusted to negative in 19 patients. The pO2-adjusted indirect Fick method incorporates the effect of dissolved O2 in hemodynamical data calculation, reducing overestimation of pulmonary / systemic blood flow ratio and underestimation of pulmonary vascular resistance in vasoreactivity testing by inhaling O2 for patients with simple CHDs.

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Acknowledgements

We would like to thank all the patients and staff of the Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and Department of Cardiology, Beijing Sixth Hospital for their valuable contributions to this study. These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Funding

This research was supported by National Key Research and Development Program of China (grant number: 2022YFC2703900 and 2022YFC2703901) and CAMS Innovation Fund for Medical Sciences (CIFMS) (grant number: 2021-I2M-1-018).

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Author notes

  1. These authors contributed equally: Kai Sun, Rui Jiang, Xi-Qi Xu

Authors and Affiliations

  1. Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Lu-Hong Qiu, Pei-Ran Wang & Kai Zhang

  2. Department of Cardiology, Beijing Sixth Hospital, Beijing, China

    Xin-Hui Ning

  3. Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China

    Kai Sun

  4. Department of Adult Cardiac Surgery, Key Laboratory of Pulmonary Vascular Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Rui Jiang

  5. Neuro Cardio Vascular Diseases Center, Xuanwu Hospital, Capital Medical University, Beijing, China

    Xi-Qi Xu

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Correspondence to Kai Sun, Rui Jiang or Xi-Qi Xu.

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Qiu, LH., Wang, PR., Zhang, K. et al. The application of partial pressure of oxygen adjusted indirect Fick method in vasoreactivity testing by inhaling oxygen in congenital heart disease. Hypertens Res (2025). https://doi.org/10.1038/s41440-025-02460-0

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