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      Non-invasive ventilation improves hemorheology status in hypoxemic patients with acute myocardial infarction after PCI

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          Abstract

          Background

          Hypoxemia sometimes occurs in the emergency room in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), even in those with administration of conventional high-flow oxygen inhalation. The objective of the present study was to evaluate the effectiveness of non-invasive ventilation (NIV) in improving blood oxygen content and hemorheology in patients with AMI and hypoxemia.

          Methods

          This prospective study enrolled 50 consecutive eligible patients with AMI (aged 72.3 ± 9.5 years), who had undergone PCI and been administered high-flow oxygen but still had hypoxemia. Blood was taken before NIV and at 0.5, 1, and 2 h after NIV. Blood gases, hemorheological variables including erythrocyte deformability, erythrocyte aggregation, erythrocyte osmotic fragility, membrane fluidity, and oxidative stress level were measured.

          Results

          Blood PaO 2 increased to normal by 1 h after NIV. Assessed hemorheological variables had all improved and plasma malondialdehyde concentration decreased significantly after 2 h of NIV.

          Conclusions

          Our data suggest that NIV can help to improve blood oxygen content, hemorheological status, and minimize plasma lipid peroxidation injury in hypoxemic patients with AMI who have undergone PCI.

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          Noninvasive ventilation in acute cardiogenic pulmonary edema.

          Moyra Masson, , Fiona Sampson … (2008)
          Noninvasive ventilation (continuous positive airway pressure [CPAP] or noninvasive intermittent positive-pressure ventilation [NIPPV]) appears to be of benefit in the immediate treatment of patients with acute cardiogenic pulmonary edema and may reduce mortality. We conducted a study to determine whether noninvasive ventilation reduces mortality and whether there are important differences in outcome associated with the method of treatment (CPAP or NIPPV). In a multicenter, open, prospective, randomized, controlled trial, patients were assigned to standard oxygen therapy, CPAP (5 to 15 cm of water), or NIPPV (inspiratory pressure, 8 to 20 cm of water; expiratory pressure, 4 to 10 cm of water). The primary end point for the comparison between noninvasive ventilation and standard oxygen therapy was death within 7 days after the initiation of treatment, and the primary end point for the comparison between NIPPV and CPAP was death or intubation within 7 days. A total of 1069 patients (mean [+/-SD] age, 77.7+/-9.7 years; female sex, 56.9%) were assigned to standard oxygen therapy (367 patients), CPAP (346 patients), or NIPPV (356 patients). There was no significant difference in 7-day mortality between patients receiving standard oxygen therapy (9.8%) and those undergoing noninvasive ventilation (9.5%, P=0.87). There was no significant difference in the combined end point of death or intubation within 7 days between the two groups of patients undergoing noninvasive ventilation (11.7% for CPAP and 11.1% for NIPPV, P=0.81). As compared with standard oxygen therapy, noninvasive ventilation was associated with greater mean improvements at 1 hour after the beginning of treatment in patient-reported dyspnea (treatment difference, 0.7 on a visual-analogue scale ranging from 1 to 10; 95% confidence interval [CI], 0.2 to 1.3; P=0.008), heart rate (treatment difference, 4 beats per minute; 95% CI, 1 to 6; P=0.004), acidosis (treatment difference, pH 0.03; 95% CI, 0.02 to 0.04; P<0.001), and hypercapnia (treatment difference, 0.7 kPa [5.2 mm Hg]; 95% CI, 0.4 to 0.9; P<0.001). There were no treatment-related adverse events. In patients with acute cardiogenic pulmonary edema, noninvasive ventilation induces a more rapid improvement in respiratory distress and metabolic disturbance than does standard oxygen therapy but has no effect on short-term mortality. (Current Controlled Trials number, ISRCTN07448447.) 2008 Massachusetts Medical Society
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            Involvements of the lipid peroxidation product, HNE, in the pathogenesis and progression of Alzheimer's disease.

            D. Butterfield, Miranda Bader Lange, Rukhsana Sultana (2010)
            Alzheimer's disease (AD) is an age-related neurodegenerative disorder. A number of hypotheses have been proposed to explain AD pathogenesis. One such hypothesis proposed to explain AD pathogenesis is the oxidative stress hypothesis. Increased levels of oxidative stress markers including the markers of lipid peroxidation such as acrolein, 4-hydroxy-2-trans-nonenal (HNE), malondialdehyde, etc. are found in brains of AD subjects. In this review, we focus principally on research conducted in the area of HNE in the central nervous system (CNS) of AD and mild cognitive impairment (MCI), and further, we discuss likely consequences of lipid peroxidation with respect to AD pathogenesis and progression. Based on the research conducted so far in the area of lipid peroxidation, it is suggested that lipid accessible antioxidant molecules could be a promising therapeutic approach to treat or slow progression of MCI and AD. Copyright 2010 Elsevier B.V. All rights reserved.
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              Lipid and protein oxidation and antioxidant status in patients with angiographically proven coronary artery disease.

              Emre Sarandol, Dilek Yeşilbursa, Melahat Dirican … (2006)
              We aimed to evaluate the association of lipid peroxidation, protein oxidation and antioxidant system, and to assess an association with the severity of the disease, in patients with and without coronary artery disease (CAD) documented by coronary angiography. The population included 208 patients, undergoing clinically indicated coronary angiography. While the subjects with normal coronary angiograms (n=54) were evaluated as controls, the patients with CAD (n=154) were divided into three categories according to the number of diseased coronaries; one-vessel (n=50), two-vessels (n=51) and three-vessels (n=53). Lipid parameters were determined by routine laboratory methods. Plasma malondialdehyde and vitamin E concentrations were determined with the high-performance liquid chromatography. Other oxidant and antioxidant parameters were studied spectrophotometrically. While plasma malondialdehyde levels, the susceptibilities of erythrocyte and apolipoprotein B containing lipoproteins to in vitro induced oxidative stress, serum protein carbonyls, low density lipoprotein-cholesterol, triglyceride, apolipoprotein B and lipoprotein (a) levels had significantly increased, high-density lipoprotein-cholesterol and apolipoprotein AI levels, erythrocyte glutathione peroxidase, glutathione reductase, glucose 6 phosphate dehydrogenase, serum catalase, paraoxonase and arylesterase activities, plasma vitamin E and C and carotenoid levels had significantly decreased. The odds ratios for one-, two-, and three-vessel disease increased across especially higher tertiles of concentrations for oxidation parameters and lower tertiles of concentrations for antioxidant parameters. According to the results, we suggest that increased lipid and protein oxidation products and decreased antioxidant enzymes and vitamins contribute to increased oxidative stress which in turn is related to the severity of the disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Geriatr Cardiol
                Journal ID (iso-abbrev): J Geriatr Cardiol
                Journal ID (publisher-id): JGC
                Title: Journal of Geriatric Cardiology : JGC
                Publisher: Science Press
                ISSN (Print): 1671-5411
                Publication date (Print): April 2017
                Volume: 14
                Issue: 4
                Pages: 274-279
                Affiliations
                [1 ]Department of Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
                [2 ]Department of Cardiology, Peking University Shougang Hospital, Beijing, China
                [3 ]Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
                Author notes
                Correspondence to: Yu-Jie ZENG, Department of Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing 100029, China. E-mail address: zengyujiedxx@ 123456sina.com Telephone:86-10-6445-6671 Fax:86-10-6445-6671
                Article
                Publisher ID: jgc-14-04-274
                DOI: 10.11909/j.issn.1671-5411.2017.04.007
                PMC ID: 5483597
                PubMed ID: 28663766
                SO-VID: e60faf0f-d194-49ff-8126-2b03d1f1c1f1
                Copyright © Institute of Geriatric Cardiology
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.

                History
                Date received : 19 December 2016
                Date revision received : 12 February 2017
                Date accepted : 21 March 2017
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: acute myocardial infarction,hypoxemia,non-invasive ventilation,percutaneous coronary intervention
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: acute myocardial infarction, hypoxemia, non-invasive ventilation, percutaneous coronary intervention

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