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Clinical Articles, Lead Article

Does giving oxygen to chest pain patients always help?

A team of researchers from the University of Leeds is to question whether the well-established practice of giving extra oxygen to patients with chest pain may unexpectedly reduce coronary flow. As part of a research project funded by Heart Research UK, Professors John Greenwood and Sven Plein, and Clinical Research Fellow Dr David Ripley make up the research team at the University of Leeds.

The project will use magnetic resonance imaging (MRI) to measure the blood flow to the heart muscle and assess the oxygen levels in the heart tissues. The team has already carried out pilot work and found that breathing high flow oxygen reduced the blood flow to the heart muscle by 18% in patients with severe coronary heart disease and 15% in healthy volunteers.

Professor Greenwood said: “We’re delighted to have received this grant from Heart Research UK as it will allow us to investigate in detail the effects of high-flow oxygen therapy and to see whether or not in patients with coronary artery disease, too much oxygen could have potentially adverse effects.”

Barbara Harpham, National Director at Heart Research UK says: “This study is really interesting and will use state-of-the art imaging techniques to look at the effects of breathing extra oxygen on blood flow to the heart muscle.  We hope that the research will give us new insights into the best ways of treating heart patients.”

Screen shot 2014-09-26 at 10.24.24

Dr David Ripley (University of Leeds)

Speaking to BJC Arrhythmia Watch, Dr Ripley said that in their analysis, which will be blinded, the team hopes to study “60 patients – 30 with cardiovascular MRI (with 30 healthy controls), and 30 with invasive physiology measurements in the cardiac catheter lab”.

“In patients presenting with acute myocardial infarction, a Cochrane systematic review indicated that the routine use of high-flow oxygen may result in a greater infarct size and increased risk of mortality,” Dr Ripley added. “In those with stable coronary disease, high-flow oxygen has been shown to prolong the electrocardiographic changes and symptoms of angina pectoris.”

“In terms of hard clinical outcomes, hyperoxaemia is also associated with increased mortality in patients with stroke, traumatic brain injury, survivors of cardiac resuscitation and critically ill patients in the intensive care unit,” he concluded.

Published on: September 26, 2014

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