Inhalation of hydrogen gas after myocardial infarctionScientific Research
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 ―
Background: In a rat model of acute myocardial infarction (AMI), hydrogen gas (HI) inhalation reduces infarct size and attenuates unnecessary left ventricular (LV) remodeling. We designed a prospective, open-label, rater-blind clinical study of patients with ST-segment elevation myocardial infarction (STEMI).
METHODS AND RESULTS
Twenty patients with an initial diagnosis of STEMI were assigned to either the HI group (1.3% H2 and 26% oxygen) or the control group (26% oxygen).
There were no serious adverse events related to HI. In the entire analysis set, the cardiac salvage index assessed by cardiac magnetic resonance imaging 7 days after primary percutaneous coronary intervention (PCI) showed no significant difference between the two groups (HI: 50.0 ± 24.3%; control group: 60.1 ± 20.1%; P = 0.43). However, at 6 months, some surrogate outcomes from day 7 were numerically greater in the HI group than in the control group, including the LV stroke volume index (HI: 9.2 ± 7.1 mL/m2; control: -1.4 ± 7.2 ml /m2; P = 0.03) and LV ejection fraction (HI: 11.0% ± 9.3%; control: 1.7% ± 8.3%; P = 0,11).
The first clinical study demonstrated that HI during PCI is feasible and safe, promoting reverse LV remodeling even 6 months after STEMI. The study was not designed to test efficacy, and another large-scale study is needed. (Clinical trial registration number: UMIN00006825)
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