Hönemann, J. and Gerlach, D.A. and Hoffmann, F. and Kramer, T. and Weis, H. and Zaha, V. and Sadek, H. and Reuter, H. and Baldus, S. and Levine, B.D. and Jordan, J. and Tank, J. and Limper, U. (2022) Cardiac safety of prolonged hypoxia exposure in fully revascularized patients with prior myocardial infarction. In: Clinical Research in Cardiology. 88. Jahrestagung der Deutschen Gesellschaft für Kardiologie, 20.-23. April 2022, Mannheim, Deutschland. doi: 10.1007/s00392-022-02002-5.
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Abstract
BACKGROUND Treatments improving cardiac regeneration could transform clinical management of ischemic cardiomyopathy. In mice with experimental myocardial infarction, prolonged normobaric hypoxia exposure corresponding to around 8,000 m altitude induced myocardial mitosis and improved left ventricular function. We determined whether a similar approach could be feasible and safe in patients. METHODS We included four highly selected men with myocardial infarction in their history (3x STEMI, 1x NSTEMI). Patients had coronary 1-vessel disease with a fully revascularized LAD stenosis as culprit lesion. The study, which was conducted at the :envihab facility, included a two-day baseline, 19 days normobaric hypoxia, and a two-day recovery period. Atmospheric oxygen was gradually lowered to 11.8% and maintained at that level for 4 days. We obtained transthoracic echocardiography, magnetic resonance imaging of the heart and the brain at baseline, during 11.8% oxygen, and recovery, and daily 12-lead ECG. RESULTS Except for symptoms of acute mountain sickness, which improved over time, hypoxia was well tolerated and severe adverse reactions did not occur. Echocardiography revealed hypoxia-induced pulmonary hypertension, which rapidly abated during recovery. Mean left ventricular ejection fraction was 50.7±11.0 % (mean±SD) at baseline, 57.6±11.2 % during hypoxia, and 57.3±11.2 following recovery (p=0.045). Cardiac magnetic resonance imaging confirmed the finding. In patients with elevated NTproBNP at baseline, the measurement was decreased during hypoxia and following recovery. Troponin I concentrations remained in the reference range throughout the study. CONCLUSIONS In a small number of fully revascularized, highly selected patients with prior myocardial infarction, prolonged exposure to substantial normobaric hypoxia was feasible and safe despite reversible increases in pulmonary artery pressure. In fact, left ventricular ejection fraction and NTproBNP were improved during and following hypoxia exposure. Our findings provide critical information for further studies assessing influences of hypoxia on cardiac regeneration in human beings.
Item URL in elib: | https://elib.dlr.de/190435/ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Document Type: | Conference or Workshop Item (Poster) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Title: | Cardiac safety of prolonged hypoxia exposure in fully revascularized patients with prior myocardial infarction | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Authors: |
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Date: | 2022 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Clinical Research in Cardiology | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Refereed publication: | Yes | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Open Access: | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gold Open Access: | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In SCOPUS: | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In ISI Web of Science: | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DOI: | 10.1007/s00392-022-02002-5 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Status: | Published | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Keywords: | Cardiac safety; prolonged hypoxia; revascularized patients; prior myocardial infarction | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Event Title: | 88. Jahrestagung der Deutschen Gesellschaft für Kardiologie | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Event Location: | Mannheim, Deutschland | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Event Type: | national Conference | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Event Dates: | 20.-23. April 2022 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Organizer: | Deutsche Gesellschaft für Kardiologie | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
HGF - Research field: | Aeronautics, Space and Transport | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
HGF - Program: | Space | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
HGF - Program Themes: | Research under Space Conditions | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DLR - Research area: | Raumfahrt | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DLR - Program: | R FR - Research under Space Conditions | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
DLR - Research theme (Project): | R - CardioBrain | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Location: | Köln-Porz | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Institutes and Institutions: | Institute of Aerospace Medicine Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace Institute of Aerospace Medicine > Leitungsbereich ME | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Deposited By: | Schrage, Larissa | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Deposited On: | 22 Nov 2022 13:22 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Last Modified: | 22 Nov 2022 13:22 |
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