Hyperbaric oxygen therapy can improve cardiac function in healthy, aging

Published: FEBRUARY 4, 2020 18:44

The inside of one of the hyperbaric chambers used for the research at the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center. (photo credit: SAGOL CENTER FOR HYPERBARIC MEDICINE AND RESEARCH) — The inside of one of the hyperbaric chambers used for the research at the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center.

(photo credit: SAGOL CENTER FOR HYPERBARIC MEDICINE AND RESEARCH)

The study was conducted on 31 patients who underwent a 60-session treatment course

Hyperbaric oxygen therapy (HBOT) can improve heart functionality in healthy aging humans, according to a study by the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center in Be’er Ya’acov.

In this study, director of the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center Prof. Shai Efrati and Dr. Marina Leitman, head of the Echocardiography Unit and Noninvasive Cardiology Service at Shamir Medical Center, turned their attention to HBOT’s impact on cardiac function.

According to the center, the study of HBOT for cardiac function has been limited, mostly evaluating patients during and after short-term exposures. However, for the first time, the study was conducted in humans and it demonstrated that repetitive HBOT protocols have a sustained effect on heart function.

Healthy patients receiving HBOT to improve cognitive function underwent a 60-session treatment course using the Sagol Center’s regenerative HBOT protocols. Using a high-resolution echocardiography, 31 patients were evaluated before HBOT was administered and three weeks after treatment concluded to identify the sustained effect of the treatment.

HBOT includes “the inhalation of 100% oxygen at pressures exceeding one atmosphere absolute [ATA],” which is the average atmospheric pressure exerted at sea level, “in order to increase the amount of oxygen dissolved in the body tissues,” Efrati told The Jerusalem Post.

Efrati, who has been pioneering new approaches for the application of HBOT treatments that specifically focus on HBOT’s ability to trigger regeneration in the body, said that in the past HBOT was used mostly to treat chronic non-healing wounds.

“In recent years, there is growing evidence on the regenerative effects of HBOT,” he said. “We have now realized that the combined action of both hyperoxia (an excess of oxygen in the body) and hyperbaric pressure, leads to significant improvement in tissue oxygenation while targeting both oxygen and pressure sensitive genes, resulting in improved mitochondrial metabolism with anti-apoptotic (anti-cell death) and anti-inflammatory effects.”

According to Efrati, the newly developed protocols used in this study, which includes the intermittent increasing and decreasing of oxygen concentration, induces what is known as the “Hyperoxic – Hypoxic Paradox.”

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This, he said “induces stem cells proliferation and mobilization, leading to the generation of new blood vessels (angiogenesis) and tissue regeneration.”

Efrati said that during the first studies they conducted at the Sagol Center, they evaluated the beneficial effects of HBOT in treating traumatic brain injury and stroke. “However, in this study we evaluated for the first time the effect of these new regenerative HBOT protocols on the “normal” aging heart. For the first time in humans we have demonstrated that HBOT can improve cardiac function.”

Efrati said for the last 12 years his team has developed an ongoing research program “that investigates the regenerative effects of HBOT on different issues and degrees of damage. At the beginning we were focused on non-healing peripheral wounds. Then, we turned our focus to certain types of brain injuries.”

However, once the researchers found that HBOT induced many of the essential elements crucial to repairing almost any mechanism, “we initiated a complementary research program that targets other organs such as the heart and other elements related to “expected” age-related functional decline.”

Along with normal aging, there is typically a decrease in cardiac function – particularly in the mitochondrial cells of the heart, Efrati said.

“The mitochondria are the ‘powerhouse” of the cell’ [and] this is where we create energy,” he said. “HBOT’s ability to improve mitochondrial function may explain the beneficial effects that we saw in the cardiac function of this normal aging population.”

By exposing the mitochondria to the fluctuations in oxygen by the use of HBOT, the team observed “an improvement in contractility function of the heart – meaning, the heart muscle contracted more efficiency over the course of the 60-session protocol.”

Efrati said the effect was particularly evident in the left ventricle, which is the chamber responsible for pumping oxygenated blood to the rest of the body.

“This is only the beginning of our understanding of the impact of HBOT on cardiac function in a normally aging population, and a larger and more diverse cohort will be required to further evaluate our initial findings,” he said.

Asked whether this treatment could also be used on people who are predisposed to heart conditions, Efrati said the short answer is “yes,” but he stressed that more research is needed.

“As far as we know, we are the first to identify HBOT’s ability to improve cardiac function,” Efrati said. “Our study was on a group of 31 asymptomatic normal aging heart patients.

“We believe it is important to expand the scope of this study to a larger group, with both symptomatic and asymptomatic patients to understand the possibilities for HBOT as a treatment for patients with heart-related diseases,” he said.

The Sagol Center has also been studying the impact of HBOT on a variety of cognitive conditions.

“We have also conducted studies which showed positive results for the treatment of post-concussion syndrome as a result of traumatic brain injury, post-stroke recovery, fibromyalgia,” Efrati said, adding that today, medical professionals understand that “fibromyalgia is linked to issues in the brain center responsible for pain interpretation.”

Not every patient will benefit from HBOT, “which is why patient selection should be done very carefully based on the damage seen in brain imaging assessments,” he said.

“For example, if someone has a stroke, some of the tissue at the core of the stroke will die – we will not be able to recover this tissue,” Efrati said. “But, other tissue that is damaged but not fully dead... is where HBOT can help.”

“This damaged tissue, known as the metabolic dysfunction tissue (penumbra), is where we can have an impact and help recover lost function,” he said.

On the time line as to when using HBOT protocols may be put into effect on healthy aging patients in Israel, Efrati said these studies are already ongoing.

“I can’t speak too much about this, as we are in the process of developing the results of the first study for publication,” he said. “However, we believe HBOT can positively impact both cognitive and physical performance in aging adults based on what we have seen at this point.”

Efrati said they will continue pursuing this line of research as it has the ability to transform how we look at aging.

A number of research collaborations are ongoing, including research on cognitive decline, fibromyalgia and PTSD, he said.

“In addition, we have an ongoing research program on athletic performance both in professional and amateur level athletes, which looks at how HBOT may further improve performance,” he said. “Finally, we are studying the impact of HBOT on healthy aging adults to understand how HBOT may improve our health and cognitive performance as we age.”

“When you look at aging as a disease that can be measured, then it can be treated, and this is a serious area of investigation for us,” Efrati said.

The study, led by Dr. Marina Leitman, Dr. Shmuel Fuchs, Dr. Amir Hadanny, Dr. Zvi Vered and Efrati, was published in the International Journal of Cardiovascular Imaging.