Elsevier

American Heart Journal

Volume 124, Issue 5, November 1992, Pages 1151-1158
American Heart Journal

Myocardial hibernation identified by hyperbaric oxygen treatment and echocardiography in postinfarction patients: Comparison with exercise thallium scintigraphy☆

https://doi.org/10.1016/0002-8703(92)90394-BGet rights and content

Abstract

To evaluate the potential for hyperbaric oxygen (HBO) to produce transient improvement in function in areas of myocardium ischemic at rest (hibernating myocardium), 24 patients were studied within 1 week of acute myocardial infarction. Results were compared with single-photon emission computed tomography (SPECT) thallium-201 exercise scintigraphy. Echocardiography demonstrated improved contraction following HBO in 20 of 62 damaged left ventricular segments in 12 of 24 patients. Thirteen of the 28 segments and 9 of the 14 patients showing reversible ischemia on SPECT imaging showed improvement with HBO. There were eight segments with apparently normal resting contraction that showed a reversible thallium defect. Of 42 segments with fixed contraction abnormalities following HBO, eight had reversible thallium defects, four had normal thallium kinetics, and 30 had fixed thallium defects. Thus hyperbaric oxygen can demonstrate improvement in function in some segments of left ventricle after infarction. There is some overlap with viability as determined by thallium studies, but the two techniques may be complementary in describing myocardial ischemia.

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      Citation Excerpt :

      Other mechanisms may be responsible for improved regional wall motion. Through favorable changes in myocardial oxygen supply and demand, HBO improved contraction of hibernating myocardium after myocardial infarction that is indicated in the study conducted by Swift et al.21 In our study, the increase of global left ventricular function is followed by improvement of global systolic function in HBO+ patients compared with the HBO− group. During left ventricular remodeling, there are structural changes in coronary microcirculation followed by decreased capillary density, with enlarged diffusion distances for oxygen and disturbed perfusion of the capillary bed.22

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    ☆

    Supported in part by the Board of Management, Fremantle Hospital, and by Rotary International, Fremantle.

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    Copyright © 1992 Published by Mosby, Inc.