ArticlePublisher preview available

The effect of hyperbaric oxygenation therapy on myocardial function

May 2020
The International Journal of Cardiovascular Imaging 36(11)

DOI:10.1007/s10554-020-01773-0

Authors:

Marina Leitman

Assaf Harofeh Medical Center, affiliated to the Tel Aviv University

Shai Efrati

Tel Aviv University

Amir Hadanny

Assaf Harofeh Medical Center

Show all 5 authorsHide

Hyperbaric oxygenation therapy is successfully implemented for the treatment of several disorders. Data on the effect of hyperbaric oxygenation on echocardiographic parameters in asymptomatic patients is limited. The current study sought to evaluate the effect of hyperbaric oxygenation therapy on echocardiographic parameters in asymptomatic patients. Thirty-one consecutive patients underwent a 60-sessions course of hyperbaric oxygenation therapy in an attempt to improve cognitive impairment. In all subjects, echocardiography examination was performed before and after a course of hyperbaric oxygenation therapy. Conventional and speckle tracking imaging parameters were calculated and analyzed. The mean age was 70 ± 9.5 years, 28 [90%] were males. History of coronary artery disease was present in 12 [39%]. 94% suffered from hypertension, 42% had diabetes mellitus. Baseline wall motion abnormalities were found in eight patients, however, global ejection fraction was within normal limits. During the study, ejection fraction [EF], increased from 60.71 ± 6.02 to 62.29 ± 5.19%, p = 0.02. Left ventricular end systolic volume [LVESV], decreased from 38.08 ± 13.30 to 35.39 ± 13.32 ml, p = 0.01. Myocardial performance index [MPi] improved, from 0.29 ± 0.07 to 0.26 ± 0.08, p = 0.03. Left ventricular [LV] global longitudinal strain increased from − 19.31 ± 3.17% to − 20.16 ± 3.34%, p = 0.036 due to improvement in regional strain in the apical and antero-septal segments. Twist increased from 18.32 ± 6.61° to 23.12 ± 6.35° p = 0.01, due to improvement in the apical rotation, from 11.76 ± 4.40° to 16.10 ± 5.56°, p = 0.004. Hyperbaric oxygen therapy appears to improve left ventricular function, especially in the apical segments, and is associated with better cardiac performance. If our results are confirmed in further studies, HBOT can be used in many patients with heart failure and systolic dysfunction.

Speckle tracking imaging results of a 68-year old healthy man before [Left image] and after hyperbaric oxygenation therapy [Right image]. a Apical 4-chamber view, regional longitudinal strain: yellow—septal basal, bright blue—mid-septal, green—septo-apical, purple—latero-apical, blue—mid-lateral, red—lateral basal. Dotted curve—global strain from the 4-chamber view. In all the segments regional strain after hyperbaric oxygenation is higher, especially apical strain [green and purple curves]. b Apical 2-chamber view, regional longitudinal strain: yellow—infero-basal, bright blue—mid-inferior, green—infero-apical, purple—antero-apical, blue—mid-anterior, red—antero-basal. Dotted line—global strain from the 2-chamber view. The regional strain is higher after hyperbaric oxygenation therapy, especially in the apical segments. c Apical 3-chamber view, regional strain: yellow—postero-basal, bright blue—mid-posterior, green—postero-apical, purple—antero-septo-apical, blue—mid-septal, red—antero-septal basal. Dotted line—global strain from the 3-chamber view. The regional strain is higher in the apical and septal segments after hyperbaric oxygenation therapy. d Twist and rotation of the left ventricle, obtained from the short axis basal and apical views. White curve—twist, blue—apical rotation, purple—basal rotation. After hyperbaric oxygenation therapy twist is higher primarily due to higher apical rotation

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The International Journal of Cardiovascular Imaging (2020) 36:833–840

https://doi.org/10.1007/s10554-020-01773-0

ORIGINAL PAPER

The eect ofhyperbaric oxygenation therapy onmyocardial function

MarinaLeitman1,3· ShaiEfrati2,3,4· ShmuelFuchs1,3· AmirHadanny2,3,4· ZviVered1,3

Received: 25 May 2019 / Accepted: 7 January 2020 / Published online: 17 January 2020

Abstract

Hyperbaric oxygenation therapy is successfully implemented for the treatment of several disorders. Data on the eﬀect of

hyperbaric oxygenation on echocardiographic parameters in asymptomatic patients is limited. The current study sought to

evaluate the eﬀect of hyperbaric oxygenation therapy on echocardiographic parameters in asymptomatic patients. Thirty-one

consecutive patients underwent a 60-sessions course of hyperbaric oxygenation therapy in an attempt to improve cognitive

impairment. In all subjects, echocardiography examination was performed before and after a course of hyperbaric oxy-

genation therapy. Conventional and speckle tracking imaging parameters were calculated and analyzed. The mean age was

70 ± 9.5years, 28 [90%] were males. History of coronary artery disease was present in 12 [39%]. 94% suﬀered from hyperten-

sion, 42% had diabetes mellitus. Baseline wall motion abnormalities were found in eight patients, however, global ejection

fraction was within normal limits. During the study, ejection fraction [EF], increased from 60.71 ± 6.02 to 62.29 ± 5.19%,

p = 0.02. Left ventricular end systolic volume [LVESV], decreased from 38.08 ± 13.30 to 35.39 ± 13.32ml, p = 0.01. Myocar-

dial performance index [MPi] improved, from 0.29 ± 0.07 to 0.26 ± 0.08, p = 0.03. Left ventricular [LV] global longitudinal

strain increased from − 19.31 ± 3.17% to − 20.16 ± 3.34%, p = 0.036 due to improvement in regional strain in the apical and

antero-septal segments. Twist increased from 18.32 ± 6.61° to 23.12 ± 6.35° p = 0.01, due to improvement in the apical rota-

tion, from 11.76 ± 4.40° to 16.10 ± 5.56°, p = 0.004. Hyperbaric oxygen therapy appears to improve left ventricular function,

especially in the apical segments, and is associated with better cardiac performance. If our results are conﬁrmed in further

studies, HBOT can be used in many patients with heart failure and systolic dysfunction.

Keywords Hyperbaric oxygenation· Echocardiography· Cardiac function

Introduction

Hyperbaric oxygen therapy (HBOT) includes the inhalation

of 100% oxygen at pressures exceeding 1 atmosphere abso-

lute in order to enhance the amount of oxygen dissolved

in the body tissues. During HBOTtreatment, the arterial

O2tension typically exceeds 2000mmHg, and levels of

200–400mmHg occur in tissues [1]. HBOT has been applied

worldwide mostly for chronic non-healing wounds and for

diving accidents. In recent years, there is growing evidence

on the regenerative eﬀects of HBOT. It is now realized, that

the combined action of both hyperoxia and hyperbaric pres-

sure, leads to signiﬁcant improvement in tissue oxygenation

while targeting both oxygen and pressure sensitive genes,

resulting in improved mitochondrial metabolism with anti-

apoptotic and anti-inﬂammatory eﬀects [2–18]. Moreover,

these genes induce stem cells proliferation, augmented cir-

culating levels of endothelial progenitor cells and angiogen-

esis factors, which induce angiogenesis and improve blood

ﬂow in the ischemic area [2–8]. However, in human stud-

ies, which were mainly focused on brain regeneration and

neuroplasticity, it had been shown, that these eﬀects require

prolonged hyperbaric series of 40–60 sessions [6, 19–21].

Electronic supplementary material The online version of this

article (https ://doi.org/10.1007/s1055 4-020-01773 -0) contains

supplementary material, which is available to authorized users.

* Marina Leitman

marina.leitman@gmail.com

1 Department ofCardiology, Shamir Medical Center, Zeriﬁn,

Israel

2 Sagol Center forHyperbaric Medicine andResearch, Shamir

Medical Center, Zeriﬁn, Israel

3 Sackler School ofMedicine, Tel Aviv University, TelAviv,

Israel

4 Sagol School ofNeuroscience, Tel Aviv University, TelAviv,

Israel

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Physical enhancement of older adults using hyperbaric oxygen: a randomized controlled trial

Article

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Jul 2024
BMC Geriatr

Introduction Aging is associated with a progressive decline in the capacity for physical activity. The objective of the current study was to evaluate the effect of an intermittent hyperbaric oxygen therapy (HBOT) protocol on maximal physical performance and cardiac perfusion in sedentary older adults. Methods A randomized controlled clinical trial randomized 63 adults (> 64yrs) either to HBOT (n = 30) or control arms (n = 33) for three months. Primary endpoint included the maximal oxygen consumption (VO2Max) and VO2Max/Kg, on an E100 cycle ergometer. Secondary endpoints included cardiac perfusion, evaluated by magnetic resonance imaging and pulmonary function. The HBOT protocol comprised of 60 sessions administered on a daily basis, for 12 consecutive weeks, breathing 100% oxygen at 2 absolute atmospheres (ATA) for 90 min with 5-minute air breaks every 20 min. Results Following HBOT, improvements were observed in VO2Max/kg, with a significant increase of 1.91 ± 3.29 ml/kg/min indicated by a net effect size of 0.455 (p = 0.0034). Additionally, oxygen consumption measured at the first ventilatory threshold (VO2VT1) showed a significant increase by 160.03 ± 155.35 ml/min (p < 0.001) with a net effect size of 0.617. Furthermore, both cardiac blood flow (MBF) and cardiac blood volume (MBV) exhibited significant increases when compared to the control group. The net effect size for MBF was large at 0.797 (p = 0.008), while the net effect size for MBV was even larger at 0.896 (p = 0.009). Conclusion The findings of the study indicate that HBOT has the potential to improve physical performance in aging adults. The enhancements observed encompass improvements in key factors including VO2Max, and VO2VT1. An important mechanism contributing to these improvements is the heightened cardiac perfusion induced by HBOT. Trial registration ClinicalTrials.gov Identifier NCT02790541 (registration date 06/06/2016).

Safety of hyperbaric oxygen therapy in patients with heart failure: A retrospective cohort study

Article

Full-text available

Feb 2024
PLOS ONE

Background Hyperbaric oxygen therapy (HBOT) has several hemodynamic effects including increases in afterload (due to vasoconstriction) and decreases in cardiac output. This, along with rare reports of pulmonary edema during emergency treatment, has led providers to consider HBOT relatively contraindicated in patients with reduced left ventricular ejection fraction (LVEF). However, there is limited evidence regarding the safety of elective HBOT in patients with heart failure (HF), and no existing reports of complications among patients with HF and preserved LVEF. We aimed to retrospectively review patients with preexisting diagnoses of HF who underwent elective HBOT, to analyze HBOT-related acute HF complications. Methods Research Ethics Board approvals were received to retrospectively review patient charts. Patients with a history of HF with either preserved ejection fraction (HFpEF), mid-range ejection fraction (HFmEF), or reduced ejection fraction (HFrEF) who underwent elective HBOT at two Hyperbaric Centers (Toronto General Hospital, Rouge Valley Hyperbaric Medical Centre) between June 2018 and December 2020 were reviewed. Results Twenty-three patients with a history of HF underwent HBOT, completing an average of 39 (range 6–62) consecutive sessions at 2.0 atmospheres absolute (ATA) (n = 11) or at 2.4 ATA (n = 12); only two patients received fewer than 10 sessions. Thirteen patients had HFpEF (mean LVEF 55 ± 7%), and seven patients had HFrEF (mean LVEF 35 ± 8%) as well as concomitantly decreased right ventricle function (n = 5), moderate/severe tricuspid regurgitation (n = 3), or pulmonary hypertension (n = 5). The remaining three patients had HFmEF (mean LVEF 44 ± 4%). All but one patient was receiving fluid balance therapy either with loop diuretics or dialysis. Twenty-one patients completed HBOT without complications. We observed symptoms consistent with HBOT-related HF exacerbation in two patients. One patient with HFrEF (LVEF 24%) developed dyspnea attributed to pulmonary edema after the fourth treatment, and later admitted to voluntarily holding his diuretics before the session. He was managed with increased oral diuretics as an outpatient, and ultimately completed a course of 33 HBOT sessions uneventfully. Another patient with HFpEF (LVEF 64%) developed dyspnea and desaturation after six sessions, requiring hospital admission. Acute coronary ischemia and pulmonary embolism were ruled out, and an elevated BNP and normal LVEF on echocardiogram confirmed a diagnosis of pulmonary edema in the context of HFpEF. Symptoms subsided after diuretic treatment and the patient was discharged home in stable condition, but elected not to resume HBOT. Conclusions Patients with HF, including HFpEF, may develop HF symptoms during HBOT and warrant ongoing surveillance. However, these patients can receive HBOT safely after optimization of HF therapy and fluid restriction.

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Jun 2023

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Acute pulmonary edema is a rare but severe complication of hyperbaric oxygen therapy. While patients with known cardiovascular problems may be able to withstand this therapy, rapid decompensation can still occur. Here, we present a case of a patient with known low ejection fraction and severe mitral regurgitation who developed acute pulmonary edema during the first hyperbaric treatment for a foot ulcer. This case highlights the importance of identifying patients that are high risk, such as those with moderate-to-severe cardiac disease, and pursuing other treatment options to avoid this complication.

Cell Therapy for Muscular Dystrophy

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Muscular dystrophy is a major unmet medical need associated with an inevitable progressive muscle damage and loss of function. Currently, treatment is only symptomatic and supportive. This chapter focuses on cell therapy as a potential treatment approach for muscular dystrophy. Mechanism of action of cell therapy and its ability to alter disease pathology have been discussed. A review of preclinical and clinical studies has been presented with the advantages and shortcomings of various cell types. Rationale for our treatment protocol and experience of treating muscular dystrophy patients has been discussed. Our published results have shown the efficacy of the intrathecal and intramuscular administration of autologous bone marrow mononuclear cells in different types of muscular dystrophy patients. The scores on outcome measures such as 6-minute walk distance, North star ambulatory assessment, Brooke and Vignose scale, Functional independence measure, and manual muscle testing either improved or were maintained suggestive of slowing down disease progression. Efficacy and safety of the treatment was also studied using comparative MRI-MSK and EMG showing decreased fatty infiltration in various muscles post-cellular therapy. Thus, it was found that autologous BMMNC transplantation is a safe and effective treatment option and improves the quality of life of MD patients.

Safety of hyperbaric oxygen therapy in patients with heart failure: A retrospective review

Preprint

Full-text available

Oct 2023

Background: Hyperbaric oxygen therapy (HBOT) has several hemodynamic effects including increases in afterload (due to vasoconstriction) and decreases in cardiac output. This, along with rare reports of pulmonary edema during emergency treatment, has led providers to consider HBOT relatively contraindicated in patients with reduced left ventricular ejection fraction (LVEF). However, there is limited evidence regarding the safety of elective HBOT in patients with heart failure (HF), and no existing reports of complications among patients with HF and preserved LVEF. We aimed to retrospectively review patients with preexisting diagnoses of HF who underwent elective HBOT, to analyze HBOT-related acute HF complications. Methods: Research Ethics Board approval was received to retrospectively review patient charts. Patients with a history of HF with either preserved ejection fraction (HFpEF), mid-range ejection fraction (HFmEF), or reduced ejection fraction (HFrEF) who underwent elective HBOT at two Hyperbaric Centers (Toronto General Hospital, Rouge Valley Hyperbaric Medical Centre) between June 2018 and December 2020 were reviewed. Results: Twenty-three patients with a history of HF underwent HBOT, completing an average of 39 (range 6 – 62) consecutive sessions at 2.0 atmospheres absolute (ATA) (n=11) or at 2.4 ATA (n=12); only two patients received fewer than 10 sessions. Thirteen patients had HFpEF (mean LVEF 55 ± 7%), and seven patients had HFrEF (mean LVEF 35 ± 8%) as well as concomitantly decreased right ventricle function (n=5), moderate/severe tricuspid regurgitation (n=3), or pulmonary hypertension (n=5). The remaining three patients had HFmEF (mean LVEF 44 ± 4%). All but one patient was receiving fluid balance therapy either with loop diuretics or dialysis. Twenty-one patients completed HBOT without complications. We observed symptoms consistent with HBOT-related HF exacerbation in two patients. One patient with HFrEF (LVEF 24%) developed dyspnea attributed to pulmonary edema after the fourth treatment, and later admitted to voluntarily holding his diuretics before the session. He was managed with increased oral diuretics as an outpatient, and ultimately completed a course of 33 HBOT sessions uneventfully. Another patient with HFpEF (LVEF 64%) developed dyspnea and desaturation after six sessions, requiring hospital admission. Acute coronary ischemia and pulmonary embolism were ruled out, and an elevated BNP and normal LVEF on echocardiogram confirmed a diagnosis of pulmonary edema in the context of HFpEF. Symptoms subsided after diuretic treatment and the patient was discharged home in stable condition, but elected not to resume HBOT. Conclusions: Patients with HF, including HFpEF, may develop HF symptoms during HBOT and warrant ongoing surveillance. However, these patients can receive HBOT safely after optimization of HF therapy and fluid restriction.

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洁黄

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Hyperbaric oxygen therapy (HBOT) is effective for the medical treatment of diverse diseases, infections, and tissue injury. In fact, in recent years there is growing evidence on the beneficial effect of HBOT on non-healing ischemic wounds. However, there is still yet discussion on how this treatment could benefit from combination with regenerative medicine strategies. Here we analyzed the effects of HBOT on three specific aspects of tissue growth, maintenance, and regeneration: (i) modulation of adult rodent (Mus musculus) intestinal stem cell turnover rates; (ii) angiogenesis dynamics during the development of the chorio-allantoic membrane (CAM) in Gallus gallus embryos; (iii) and wound-healing in a spontaneous type II diabetic mouse model with a low capacity to regenerate skin. To analyze these aspects of tissue growth, maintenance, and regeneration, we used HBOT alone or in combination with cellular therapy. Specifically, Wharton Jelly Mesenchymal Stem cells (WJ-MSC) were embedded in a commercial collagen-scaffold. HBOT did not affect the metabolic rate of adult mice nor of chicken embryos. Notwithstanding, HBOT modified the proliferation rate of stem cells in the mice small intestinal crypts, increased angiogenesis in the CAM, and improved wound-healing and tissue repair in diabetic mice. Moreover, our study demonstrates that combining stem cell therapy and HBOT has a collaborative effect on wound-healing. In summary, our data underscore the importance of oxygen tension as a regulator of stem cell biology and support the potential use of oxygenation in clinical treatments.

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Erectile dysfunction (ED) is caused by microvascular or macrovascular insufficiency in the majority of patients. Recent studies have shown that hyperbaric oxygen therapy (HBOT) can induce angiogenesis in different body organs. The effect of HBOT on the non-surgery-related ED has not been investigated yet. The aim of the current study was to evaluate the effects of HBOT on sexual function and penile vascular bed in non-surgical ED patients. A prospective analysis of patients suffering from chronic ED treated with 40 daily HBOT sessions. Clinical efficacy was assessed using the International Index of Erectile Function questionnaire (IIEF) and a global efficacy question (GEQ). The effect on the penile vascular bed was evaluated by perfusion MRI. Thirty men (mean age of 59.2 ± 1.4) suffering from ED for 4.2 ± 0.6 years completed the protocol. HBOT significantly improved all IIEF domains by 15-88% (p < 0.01). Erectile function improved by 88% (p < 0.0001) and 80% of the patients reported positive outcome according to the GEQ. Angiogenesis was indicated by perfusion MRI that showed a significant increase by 153.3 ± 43.2% of K-trans values in the corpous cavernous (p < 0.0001). HBOT can induce penile angiogenesis and improve erectile function in men suffering from EcD. HBOT reverses the basic common pathophysiology, atherosclerosis and decreased penile perfusion, responsible for most cases of ED.

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Hyperbaric oxygen treatment (HBO) promotes rapid recovery from soft tissue injuries. However, the healing mechanism is unclear. Here we assessed the effects of HBO on contused calf muscles in a rat skeletal muscle injury model. An experimental HBO chamber was developed and rats were treated with 100% oxygen, 2.5 atmospheres absolute for 2 h/day after injury. HBO reduced early lower limb volume and muscle wet weight in contused muscles, and promoted muscle isometric strength 7 days after injury. HBO suppressed the elevation of circulating macrophages in the acute phase and then accelerated macrophage invasion into the contused muscle. This environment also increased the number of proliferating and differentiating satellite cells and the amount of regenerated muscle fibers. In the early phase after injury, HBO stimulated the IL-6/STAT3 pathway in contused muscles. Our results demonstrate that HBO has a dual role in decreasing inflammation and accelerating myogenesis in muscle contusion injuries.

Influence of hyperoxia on diastolic myocardial and arterial endothelial function

Article

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Nov 2017
UNDERSEA HYPERBAR M

Objective: Hyperoxia is known to influence cardiovascular and endothelial function, but it is unknown if there are differences between younger and older persons. The aim of this study was to monitor changes in myocardial diastolic function and flow-mediated dilatation (FMD) in younger and elderly volunteers, before and after exposure to relevant hyperbaric hyperoxia. Methods: 51 male patients were separated into two groups for this study. Volunteers in Group 1 (n=28, mean age 26 ±6, "juniors") and Group 2 (n=23, mean age 53 ±9, "seniors") received standard HBO₂ protocol (240kPa oxygen). Directly before and after hyperoxic exposure in a hyperbaric chamber we took blood samples (BNP, hs-troponin-t), assessed the FMD and echocardiographic parameters with focus on diastolic function. Results: After hyperoxia we observed a high significant decrease in heart rate and systolic/diastolic FMD. Diastolic function varied in both groups: E/A ratio showed a statistically significant increase in Group 1 and remained unchanged in Group 2. E/e' ratio showed a slight but significant increase in Group 1, whereas e'/a' ratio increased in both groups. Deceleration time increased significantly in all volunteers. Isovolumetric relaxation time remained unchanged and ejection fraction showed a decrease only in Group 2. There were no changes in levels of BNP and hs-troponin-t in either group. Conclusion: Hyperoxia seems to influence endothelial function differently in juniors and seniors: FMD decreases more in seniors, possibly attributable to pre-existing reduced vascular compliance. Hyperoxia-induced bradycardia induced a more pronounced improvement in diastolic function in juniors. The ability of Group 1 to cope with hyperoxia-induced effects did not work in the same manner as with Group 2.

Hyperbaric oxygen affects endothelial progenitor cells proliferation in vitro

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Oct 2018

The Effect of Hyperbaric Oxygen Therapy on Myocardial Perfusion after the Implantation of Drug-Eluting Stents

Article

Mar 2018

Aim: The study is to investigate hyperbaric oxygen therapy (HBOT) on myocardial perfusion of patients after the implantation of drug-eluting stents (DES) METHODS: From December 2013 to December 2015, a total of 115 patients with CAD who received DES implantation were included in this retrospective study. They were divided into HBOT group (n=55) and control group (n=60) according to different treatments retrospectively. Gated myocardial perfusion single photon emission computed tomography (SPECT) was conducted in all the patients. Endothelin-1 (ET-1), high sensitivity C reactive protein (hs-CRP) and nitric oxide (NO) were detected by the corresponding assay kits. Results: After HBOT treatment in HBOT group, SPECT results showed that the improvement rate of impaired sub-segments in patients of HBOT was significantly higher than that in control group (P<0.05), and the parameters of PFR, TPFR, MFR/3 were displayed with marked differences between the two groups (P<0.05). The laboratory results demonstrated a statistically increased level of NO and decreased levels of ET-1 and hs-CRP between the two groups (P<0.05). Conclusions: HBO may improve myocardial blood perfusion, reduce inflammation and vascular endothelial dysfunction, and further improve myocardial microcirculation in patients after the implantation of drug-eluting stents.

Hyperbaric Oxygen Therapy Side Effects – Where Do We Stand?

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Feb 2018

Marvin Heyboer

Effect of hyperbaric oxygen therapy on blood pressure in patients undergoing treatment

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Mar 2017
UNDERSEA HYPERBAR M

Introduction: Hyperbaric oxygen (HBO₂) therapy is generally safe and well tolerated. However, known side effects do exist. Elevation in the blood pressure of patients undergoing HBO₂ therapy is a less defined potential side effect. We sought to better quantify effects of HBO₂ on blood pressure (BP) in patients undergoing HBO₂. Methods: A retrospective chart review was performed on quality assurance data captured on all patients undergoing HBO₂ between March 2012 and October 2015 at a large tertiary referral university hospital hyperbaric center. Results: We identified 155 patients who received 3,147 hyperbaric oxygen treatments. For all treatments there was an overall increase in the median systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) following treatment. No statistically significant difference was found when comparing patients with and without hypertension. Calcium channel blockers (CCB) and beta-blockers (BB) were found to have an agonizing effect while ACE inhibitors (ACEI) were found to have a protective effect. The change in SBP was less with each additional treatment in patients undergoing more than one treatment. Discussion: The current study demonstrates that absolute rises in blood pressure do occur as a result of HBO₂ therapy. However, the extent of this effect is not large. BB and CCB had agonizing effects while ACEI had a protective effect. Finally, there was a protective effect with more treatments.

The effect of hyperbaric oxygenation therapy on myocardial function

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