Hyperbaric oxygen treatment does not affect left ventricular chamber stiffness after myocardial infarction treated with thrombolysis.
BACKGROUND
It has been shown that transient increase in left ventricular stiffness, assessed by Doppler-derived early filling deceleration time, occurs during the first 24 to 48 hours after myocardial infarction but returns to normal within several days. It has been reported that hyperbaric oxygen treatment has a favorable effect on left ventricular systolic function in patients with acute myocardial infarction treated with thrombolysis. However, there are no data on the effects of hyperbaric oxygen on diastolic function after myocardial infarction.


METHODS
To assess acute and short-term effects of hyperbaric oxygen on left ventricular chamber stiffness, we studied 74 consecutive patients with first acute myocardial infarction who were randomly assigned to treatment with hyperbaric oxygen combined with streptokinase or streptokinase alone. After thrombolysis, patients in the hyperbaric oxygen group received 100% oxygen at 2 atm for 60 minutes in a hyperbaric chamber. All patients underwent 2-dimensional and Doppler echocardiography 1 (after thrombolysis), 2, 3, 7, 21, and 42 days after myocardial infarction.


RESULTS
Patient characteristics, including age, sex, risk factors, adjunctive postinfarction therapy, infarct location, and baseline left ventricular volumes and ejection fraction, were similar between groups (P >.05 for all). For both groups, deceleration time decreased nonsignificantly from day 1 to day 3 and increased on day 7 (P <.001, for both groups), increasing nonsignificantly subsequently. The E/A ratio increased in the entire study group throughout the time of study (P <.001, for both groups). The pattern of changes of deceleration time was similar in both groups (P >.05 by analysis of variance), as was in subgroups determined by early reperfusion success.


CONCLUSIONS
These data in a small clinical trial do not support a benefit of hyperbaric oxygen on left ventricular diastolic filling in patients with acute myocardial infarction treated with thrombolysis.
Vlahović
Alja
A
Dr Aleksandar D. Popović Cardiovascular Research Center, Dedinje Cardiovascular Institute, Belgrade, Serbia and Montenegro, Yugoslavia.
Nesković
Aleksandar N
AN
Dekleva
Milica
M
Putniković
Biljana
B
Popović
Zoran B
ZB
Otasević
Petar
P
Ostojić
Miodrag
M
D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors; D013300:Streptokinase / Q000627:therapeutic use*; D015912:Thrombolytic Therapy; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016277:Ventricular Function, Left
D005343:Fibrinolytic Agents; D013300:Streptokinase