title: Initial experience with hyperoxemic reperfusion after primary angioplasty for acute myocardial infarction: results of a pilot study utilizing intracoronary aqueous oxygen therapy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the feasibility and safety of intracoronary hyperoxemic reperfusion after primary angioplasty for acute myocardial infarction (MI).
  
  
  BACKGROUND
  Hyperoxemic therapy with aqueous oxygen (AO) attenuates reperfusion injury and preserves left ventricular (LV) function in experimental models of MI.
  
  
  METHODS
  In a multi-center study of patients with acute MI undergoing primary angioplasty (PTCA), hyperoxemic blood (pO(2): 600 to 800 mm Hg) was infused into the infarct-related artery for 60 to 90 min after intervention. The primary end points were clinical, electrical and hemodynamic stability during hyperoxemic reperfusion and in-hospital major adverse cardiac events. Global and regional LV function was evaluated by serial echocardiography after PTCA, after AO infusion, at 24 h and at one and three months.
  
  
  RESULTS
  Twenty-nine patients were enrolled (mean age: 58.9+/-12.6 years). Hyperoxemic reperfusion was performed successfully in all cases (mean infusion time: 80.8+/-18.2 min; mean coronary perfusate pO(2): 631+/-235 mm Hg). There were no adverse events during hyperoxemic reperfusion or the in-hospital period. Compared with baseline, a significant improvement in global wall motion score index was observed at 24 h (1.68+/-0.24 vs. 1.48+/-0.24, p < 0.001) with a trend toward an increase in ejection fraction (48.6+/-7.3% vs. 51.8+/-6.8%, p = 0.08). Progressive improvement in LV function was observed at one and three months, primarily due to recovery of infarct zone function.
  
  
  CONCLUSIONS
  Intracoronary hyperoxemic reperfusion is safe and well tolerated after primary PTCA. These preliminary data support the need for a randomized controlled trial to determine if hyperoxemic reperfusion enhances myocardial salvage or improves long-term outcome.
authors.affiliation: Division of Cardiology, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Dixon
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Marcovitz
authors.forename: Richard
authors.initials: R
authors.lastname: Spears
authors.forename: Shukri
authors.initials: S
authors.lastname: David
authors.forename: Issac
authors.initials: I
authors.lastname: Grinberg
authors.forename: Mansoor A
authors.initials: MA
authors.lastname: Qureshi
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
authors.forename: Daniela
authors.initials: D
authors.lastname: Trabattoni
authors.forename: Franco
authors.initials: F
authors.lastname: Fabbiocchi
authors.forename: Piero
authors.initials: P
authors.lastname: Montorsi
authors.forename: William W
authors.initials: WW
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D004452:Echocardiography; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D015425:Myocardial Reperfusion; D010100:Oxygen / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy; D010865:Pilot Projects; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects / Q000502:physiology; D011859:Radiography; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D013997:Time Factors; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
chemical_list: D010100:Oxygen