N-terminal pro-B-type natriuretic peptide levels increases after hyperbaric oxygen therapy in diabetic patients.
OBJECTIVE
Diabetic patients receive hyperbaric oxygen therapy for non-healing lower extremity ulcers. Exposure to hyperbaric hyperoxia during hyperbaric oxygen therapy may affect cardiovascular functions by different mechanisms. Patients may experience serious problems such as pulmonary edema and death during hyperbaric oxygen therapy. The effect of hyperbaric oxygen therapy on cardiovascular functions in diabetic patients is not well documented. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been suggested as powerful biochemical marker of cardiac function. The aim of this study was to investigate the effect of hyperbaric oxygen therapy on NT-proBNP levels in diabetic patients.


METHODS
Twenty-five diabetic patients (19 male and 6 female, 64.7 +/- 10.2 yr), who were planning to undergo hyperbaric oxygen therapy for non-healing lower extremity ulcers, were prospectively enrolled into the study. All patients were evaluated with echocardiography before the study. Heart rate and arterial blood pressure of patients were measured, and venous blood samples were drawn from each patient for NT-proBNP analysis before and immediately after the hyperbaric oxygen therapy.


RESULTS
NT-proBNP levels increased from 815 +/- 1096 pg/ml to 915 +/- 1191 pg/ml after HBO2 therapy (P < 0.05). Heart rate and arterial blood pressure did not change with HBO2 therapy (P > 0.05).


CONCLUSIONS
Hyperbaric oxygen therapy induces considerable ventricular wall stress in diabetic patients. Care should be taken when a diabetic patient with cardiovascular disease is treated with hyperbaric oxygen therapy.
Yildiz
Senol
S
Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy Haydarpasa Teaching Hospital, 34668, Uskudar, Istanbul, Turkey.
Uzun
Gunalp
G
Uz
Omer
O
Ipcioglu
Osman Metin
OM
Kardesoglu
Ejder
E
Ozcan
Omer
O
D000368:Aged; D015415:Biomarkers / Q000097:blood; D017719:Diabetic Foot / Q000097:blood* / Q000628:therapy*; D005260:Female; D006352:Heart Ventricles / Q000378:metabolism; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain