title: Hyperbaric oxygen: a new drug in myocardial revascularization and protection?
abstract: Ischemia-reperfusion injury (IRI) occurs following coronary artery revascularization. Reactive oxygen species (ROS) were initially thought to play a role in the pathogenesis of this injury. However, the evidence for this is inconclusive. Recent studies involving ischemic preconditioning have identified ROS as potential mediators for the cardioprotective effects observed following this technique. Furthermore, cardiac studies involving IRI and the use of hyperbaric oxygen (HBO) have demonstrated the ability of HBO to induce cardioprotection and to attenuate IRI. This review suggests the possible role for HBO as a new drug in the arena of myocardial revascularization and cellular protection. While there is mounting clinical evidence for this, a methodological understanding of HBO's cellular mechanisms of actions appears to be lacking. As such, this article attempts to draw the similarity between HBO and other protective oxidative stress mechanisms and then to speculate in an evidence-based manner its possible cellular mechanistic role as a drug via the generation of ROS.
authors.affiliation: Department of Cardiothoracic Surgery, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, United Kingdom. jeysenzy@msn.com
authors.forename: Jeysen Zivan
authors.initials: JZ
authors.lastname: Yogaratnam
authors.forename: Gerard
authors.initials: G
authors.lastname: Laden
authors.forename: Leigh Anthony
authors.initials: LA
authors.lastname: Madden
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Seymour
authors.forename: Levant
authors.initials: L
authors.lastname: Guvendik
authors.forename: Mike
authors.initials: M
authors.lastname: Cowen
authors.forename: John
authors.initials: J
authors.lastname: Greenman
authors.forename: Alex
authors.initials: A
authors.lastname: Cale
authors.forename: Steve
authors.initials: S
authors.lastname: Griffin
mesh_terms: D000818:Animals; D002448:Cell Adhesion; D006801:Humans; D006931:Hyperbaric Oxygenation; D018836:Inflammation Mediators / Q000378:metabolism*; D015227:Lipid Peroxidation; D015428:Myocardial Reperfusion Injury / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D009204:Myocardial Revascularization; D009504:Neutrophils / Q000378:metabolism; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000378:metabolism*
chemical_list: D018836:Inflammation Mediators; D017382:Reactive Oxygen Species