Intermittent hypoxia reduces infarct size in rats with acute myocardial infarction: a systematic review and meta-analysi
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RESEARCH ARTICLE
Open Access
Intermittent hypoxia reduces infarct size in rats with acute myocardial infarction: a systematic review and meta-analysis Ke Hu1, Wei Deng2* , Jing Yang3, Yu Wei2, Chaolin Wen2, Xingsheng Li2, Qingwei Chen2, Dazhi Ke2 and Guiqiong Li2
Abstract Background: To determine whether intermittent hypoxia (IH) can reduce the infarct size (IS) after acute myocardial infarction (AMI) in rats. Methods: Articles were identified in PubMed, EMBASE and the Web of Science and were included if they evaluated the effect of IH on the changes in the infarcted area after AMI in rats. Results: A preliminary search identified 3633 articles and 29 data sets from 23 articles (12 in vivo, 16 in vitro). The IS decreased after AMI in IH rats both in vitro (SMD -1.46, 95% CI [− 2.37, − 0.55]; I2 = 85.6%, P = 0.000) and in vivo (SMD -1.43, 95% CI [− 2.05, − 0.82], I2 = 73.6%, P = 0.000). Sensitivity analysis indicated that IH had a strong protective effect against myocardial infarction, and the hypoxia concentration was significantly correlated with the change in IS after AMI. Conclusion: IH can reduce IS after AMI in rats. This effect of IH may be related to the dose of hypoxia, and the oxygen concentration may be one of the most important influencing factors.
Background Intermittent hypoxia (IH) involves inducing the body to continuously self-regulate by repeatedly exposing the subject to a hypoxic or hypobaric hypoxia environment in a certain way [1, 2]. To construct IH animal models, experimental animals such as rats or mice are repeatedly exposed to a hypoxic environment with controlled parameters (including oxygen concentration, air pressure, daily exposure time, total duration, and mode of action). The IH animals are then subjected to coronary artery ligation (20–30 min) in vivo or in vitro. Next, the coronary artery is reperfused for 2–4 h. Finally, the myocardial
* Correspondence: [email protected] 2 Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, No. 74, Linjiang Road, Yuzhong District, Chongqing 400010, China Full list of author information is available at the end of the article
infarct area of the rats is observed and compared with a normoxic group [3, 4]. An increasing number of studies show that IH can help reduce the area of myocardial infarction in patients with coronary heart disease [5–7] or in animal models of acute myocardial infarction [8, 9]. IH can not only reduce IS but also increase the ejection fraction of the heart and reduce the occurrence of arrhythmia after AMI [8, 10, 11], IH also has protective effects on other organs of the body, such as lowering blood pressure, improving glucose tolerance, improving blood lipid levels, reducing the infarct area after acute cerebral infarction, and improving cognitive dysfunction and renal fibrosis after ischemia [1, 2, 12–15]. However, researchers also found that IH sometimes increases myocardial IS after AMI in rats [16, 17]. Therefore, we conducted a comprehensive systematic review and
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