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hyperbaric oxygen therapy (HBOT) Increased markers of cardiac function in a small randomized controlled trial in long-term COVID-19 patients.
Left ventricular global longitudinal strain (GLS) decreased at baseline, and patients who received HBOT had a significant increase in GLS compared with those who received sham treatment.
GLS is a measure of systolic function that is believed to be a predictor of heart failure-related outcomes.
The study also showed a non-significant increase in global work efficiency (GWE) and global work index (GWI) in HBOT-treated patients.
“HBOT is an effective treatment for diabetic foot ulcers, diver decompression sickness, and other conditions such as post-diver cognitive impairment. strokesaid Marina Reitman, M.D., of the Sackler College of Medicine in Tel Aviv, Israel. heart.org | Medscape Cardiology. her team Studied Using HBOT in asymptomatic elderly patients, they found that this treatment appeared to improve left ventricular end-systolic function.
“We need to be open-minded about this treatment for other indications,” she says. “This is the cornerstone of precision medicine.
“We can now say that post-corona syndrome patients should probably be assessed as follows. echocardiography “GLS is the main parameter that showed improvement in our study. These patients may benefit from HBOT if GLS is below normal, but determining the optimal number of sessions needs additional research,” she added.
Reitman presented the study on May 10 at the European Conference on Cardiovascular Imaging (EACVI) 2023, the scientific meeting of the European Society of Cardiology.
Changes in biomarkers
The study included 60 hospitalized and non-hospitalized COVID-19 patients with ongoing symptoms for at least 3 months after mild to moderately symptomatic COVID-19 infection. Patients with postsymptomatic syndrome were enrolled.
Participants were randomized to receive HBOT or sham treatment five times per week for eight weeks, for a total of 40 sessions. They underwent echocardiography to assess his GLS at baseline and 1–3 weeks after his final session.
The HBOT group received 90 minutes of 100% oxygen at 2 atm through a mask with air breaks of 5 minutes every 20 minutes.
The sham group received 21% oxygen for 90 minutes at 1 atm via a mask.
At baseline, 29 participants (48%) had normal ejection fraction but decreased GLS, Reitman said. Of those, 16 (53%) belonged to his HBOT group and 13 (43%) to the sham group.
The average GLS at baseline for all participants was -17.8%. A normal value is about -20%.
In the HBOT group, GLS increased significantly from -17.8% at baseline to -20.2% after HBOT. In the sham group, GLS was -17.8% at baseline and -19.1% at study end, but there was no statistically significant difference between the two measures.
Additionally, GWE after HBOT increased overall from 96.3 to 97.1.
Reitman’s poster showed GLS and myocardial activity index before and after HBOT in a 45-year-old patient. GLS before treatment was -19%. GWE he was 96%. GWI was 1833 mmHg.
GLS after HBOT treatment was -22%. GWE, 98%. and GWI, 1911 mm Hg.
Unclear clinical relevance
Scott Gollenstein, M.D., Associate Professor of Surgery, Dean of Medicine wound care Hyperbaric Medicine and New York University, Langon, Long Island, New York commented on the study. heart.org | Medscape Cardiology.
“This approach certainly deserves research, but its benefits are difficult to assess,” he says. “Because the mechanism of prolongation of COVID-19 is not yet understood, it is difficult to say that HBOT will be an effective treatment from there.”
That said, he added, “This is probably the best study I’ve seen in that it’s a randomized controlled trial rather than a case series.”
Nonetheless, he said, “We do not know from this study whether changes in GLS are clinically relevant. As a clinician, I cannot say now that HBOT improves.” heart failure Long-term secondary effects of COVID-19. For example, I don’t know if the participant was a NY state heart failure class 3 or 4, but suddenly they went from being awful to being very well. ”
“There are many interventions that have the potential to alter markers of cardiac function and inflammation,” he said. “But if treatment does not change the quantity or quality of life, is it really worth it?”
Gollenstein said it’s fine to treat patients with mild to moderate COVID-19-related heart failure with HBOT. study A study conducted early in the pandemic showed it to be safe. “However, HBOT is an expensive treatment in the United States, and there are still some risks and side effects, albeit very low.”
This study was not funded. Reitman and Gollenstein have not disclosed the financial relationship involved.
European Conference on Cardiovascular Imaging (EACVI) 2023. Presented on 10 May 2023.
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