H2 Inhalation and Left Ventricular Remodeling After Heart AttackScientific Research


original title: The Effects of Hydrogen Gas Inhalation on Adverse Left Ventricular Remodeling After Percutaneous Coronary Intervention for ST-Elevated Myocardial Infarction – First Pilot Study in Humans

DOI: 10.1253/circj.CJ-17-0105

Published on: 2017


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Abstract:

Background: Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI).Methods and

Results:The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events. In the full analysis set, the cardiac salvage index as evaluated using cardiac magnetic resonance imaging at 7 days after primary percutaneous coronary intervention (PCI), showed no significant between-group difference (HI: 50.0±24.3%; control: 60.1±20.1%; P=0.43). However, the improvement from day 7 in the HI group was numerically greater than that in the control group in some of the surrogate outcomes at 6-month follow-up, including the LV stroke volume index (HI: 9.2±7.1 mL/m2; control: -1.4±7.2 mL/m2; P=0.03) and the LV ejection fraction (HI: 11.0%±9.3%; control: 1.7%±8.3%; P=0.11). Conclusions: The first clinical study has shown that HI during PCI is feasible and safe and may also promote LV reverse remodeling at 6 months after STEMI. The study was not powered to test efficacy and a further large-scale trial is warranted. (Clinical trials registration: UMIN00006825).

Authors:

Eiji Kobayashi, Fumiya Sano, Ikuko Ueda, Junichi Sasaki, Keiichi Fukuda, Koichiro Homma, Masaru Suzuki, Motoaki Sano, Shigeo Okuda, Shingo Hori, Shun Kohsaka, Taishi Fujisawa, Takayuki Abe, Tomoyoshi Tamura, Yasuyuki Shiraishi, Yoshinori Katsumata, Yuichiro Maekawa