Effects of hyperbaric oxygen on vascular endothelial function in patients with slow coronary flow
Abstract
Background: To improve therapy for slow coronary flow (SCF), the effects of hyperbaric oxygen (HBO) therapy on vascular endothelial function in SCF patients is the focus of this investigation.
Methods: Ninety-eight patients who exhibited chest discomfort were retrospectively analyzed, and diagnosed with SCF by coronary artery angiography at the Third Hospital of Hebei Medical University, Shijiazhuang, China from 2014 to 2016. The patients were divided into two groups according to the following treatment: HBO group (n = 48) and the control group (n = 50). Patients in the control group were administrated with conventional treatment, while those in the HBO group were administrated HBO therapy for 4 weeks in addition to conventional treatment. To evaluate the effects of HBO on vascular endothelial functions, plasma levels of nitric oxide (NO), calcitonin gene-related peptide (CGRP), endothelin-1 (ET-1), high sensitivity C-reactive protein (hsCRP) as well as endothelial-dependent flow-mediated vasodilation (FMD) of the brachial artery were measured in both groups before and after their respective treatments.
Results: There were no significant differences in plasma levels of NO, ET-1, CGRP, hsCRP nor in FMD measurements between the two groups before treatment (p > 0.05). Moreover, the levels of all the parameters measured showed no significant changes before and after treatment in the control group. However, when comparing the control group, FMD and plasma NO and CGRP levels were significantly increased in the HBO group after treatment (p < 0.01), whereas hsCRP and ET-1 levels decreased dramatically (p < 0.001).
Conclusions: The HBO treatment in addition to conventional therapy may significantly improve the vascular endothelial function in SCF patients. (Cardiol J 2018; 25, 1: 106–112)
Keywords: slow coronary flowhyperbaric oxygenvascular endothelial function
References
- Tambe AA, Demany MA, Zimmerman HA, et al. Angina pectoris and slow flow velocity of dye in coronary arteries--a new angiographic finding. Am Heart J. 1972; 84(1): 66–71.
- Singh S, Kothari SS, Bahl VK. Coronary slow flow phenomenon: an angiographic curiosity. Indian Heart J. 2004; 56(6): 613–617.
- Fragasso G, Chierchia SL, Arioli F, et al. Coronary slow-flow causing transient myocardial hypoperfusion in patients with cardiac syndrome X: long-term clinical and functional prognosis. Int J Cardiol. 2009; 137(2): 137–144.
- Gesell, Laurie B. Hyperbaric Oxygen Therapy Indications. The Hyperbaric Oxygen Therapy Committee Report (12th ed.) 2008. Durham, NC: Undersea and Hyperbaric Medical Society.
- Gibson CM, Cannon CP, Daley WL, et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996; 93(5): 879–888.
- Signori LU, Quadros AS, Sbruzzi G, et al. Endothelial function in patients with slow coronary flow and normal coronary angiography. Clinics (Sao Paulo). 2012; 67(6): 677–680.
- Yoon HJu, Jeong MHo, Cho SH, et al. Endothelial dysfunction and increased carotid intima-media thickness in the patients with slow coronary flow. J Korean Med Sci. 2012; 27(6): 614–618.
- Pekdemir H, Polat G, Cin VG, et al. Elevated plasma endothelin-1 levels in coronary sinus during rapid right atrial pacing in patients with slow coronary flow. Int J Cardiol. 2004; 97(1): 35–41.
- Nikitenko LL, Blucher N, Fox SB, et al. Adrenomedullin and CGRP interact with endogenous calcitonin-receptor-like receptor in endothelial cells and induce its desensitisation by different mechanisms. J Cell Sci. 2006; 119(Pt 5): 910–922.
- Yurtdaş M, Yaylali YT, Kaya Y, et al. Increased plasma high-sensitivity C-reactive protein and myeloperoxidase levels may predict ischemia during myocardial perfusion imaging in slow coronary flow. Arch Med Res. 2014; 45(1): 63–69.
- Cetin M, Zencir C, Tasolar H, et al. The association of serum albumin with coronary slow flow. Wien Klin Wochenschr. 2014; 126(15-16): 468–473.
- Hawkins BM, Stavrakis S, Rousan TA, et al. Coronary slow flow--prevalence and clinical correlations. Circ J. 2012; 76(4): 936–942.
- Erdogan D, Caliskan M, Gullu H, et al. Coronary flow reserve is impaired in patients with slow coronary flow. Atherosclerosis. 2007; 191(1): 168–174.
- Liu H, Wang H. Early detection system of vascular disease and its application prospect. Biomed Res Int. 2016; 2016: 1723485.
- Bennett MH, Lehm JP, Jepson N, et al. Hyperbaric oxygen therapy for acute coronary syndrome. Cochrane Database Syst Rev. 2011(8): CD004818.
- Khan M, Meduru S, Pandian RP, et al. Effect of oxygenation on stem-cell therapy for myocardial infarction. Adv Exp Med Biol. 2011; 701: 175–181.
- Unfirer S, Kibel A, Drenjancevic-Peric I. The effect of hyperbaric oxygen therapy on blood vessel function in diabetes mellitus. Med Hypotheses. 2008; 71(5): 776–780.
- Li J, Liu W, Ding S, et al. Hyperbaric oxygen preconditioning induces tolerance against brain ischemia-reperfusion injury by upregulation of antioxidant enzymes in rats. Brain Res. 2008; 1210: 223–229.
- Cheng O, Ostrowski RP, Wu B, et al. Cyclooxygenase-2 mediates hyperbaric oxygen preconditioning in the rat model of transient global cerebral ischemia. Stroke. 2011; 42(2): 484–490.
- Tjärnström J, Holmdahl L, Falk P, et al. Effects of hyperbaric oxygen on expression of fibrinolytic factors of human endothelium in a simulated ischaemia/reperfusion situation. Scand J Clin Lab Invest. 2001; 61(7): 539–545.
- Yogaratnam JZ, Laden G, Madden LA, et al. Hyperbaric oxygen: a new drug in myocardial revascularization and protection? Cardiovasc Revasc Med. 2006; 7(3): 146–154.
- Kudchodkar BJ, Wilson J, Lacko A, et al. Hyperbaric oxygen reduces the progression and accelerates the regression of atherosclerosis in rabbits. Arterioscler Thromb Vasc Biol. 2000; 20(6): 1637–1643.
- Cakmak M, Tanriverdi H, Cakmak N, et al. Simvastatin may improve myocardial perfusion abnormality in slow coronary flow. Cardiology. 2008; 110(1): 39–44.
- Caliskan M, Erdogan D, Gullu H, et al. Effects of atorvastatin on coronary flow reserve in patients with slow coronary flow. Clin Cardiol. 2007; 30(9): 475–479.
