Hyperbaric oxygenation and structural and functional heterogenicity of platelet response in ischemic heart disease: focus on personalizing the effect: 616.15-008.1

Abstract

Summary. Background. Every day the concept of patient-oriented diagnostics and treatment becomes more and more rele- vant. At the same time, a personalized approach is important both in prescribing drug therapy and physiotherapy procedures. Objective: to reveal the significance of the individual platelet reaction to hyperbaric oxygen for the personification of hyperbaric oxygenation (HBO). Patients/Methods. From 2018 to 2021 a prospective study was conducted in the Center for Arterial Hyper- tension and Cardiorehabilitation (Ulyanovsk Regional Clinical Hospital for War Veterans): 100 patients aged 64.8 ± 10.9 years with stable ischemic heart disease were examined — 30 women aged 70.8 ± 7.6 years and 70 men aged 60.2 ± 9.4 years. Group 1 (n = 70) at the age of 65.3 ± 9.9 years, consisting of 52 (74.28%) men and 18 (25.72%) women, received standard therapy, including β-blockers, statins, inhibitors of angiotensin-converting enzyme and antiaggregant agent (acetylsalicylic acid, ASA). Group 2 (n = 30) at the age of 64.3 ± 9.9 years consisted of 18 (74.28%) men and 12 (25.72%) women with low adherence to antiaggregant therapy, who indepen- dently stopped taking ASA in the last month before the study, but continued standard therapy. The studies were carried out before and after 10-day sessions of HBO at 1.2 atm for 40 min in a single pressure chamber. Platelet aggregation, number and average platelet volume (APV), elastic properties of the platelet membrane, serum concentration of phospholipase A2 (PLA2) were deter- mined. Results. Morphometric analysis of platelet number and APV did not reveal any dependence on the presence or absence of antiaggregant therapy. In patients taking ASA, a decrease in PLA2 content (p = 0.045) and an increase in Young’s modulus (p = 0.019) after HBO course were found, that indicated the increasing of platelet membrane rigidity. Also, a multidirectional HBO effect was noted depending on gender: in men who do not take ASA, a significant decrease of PLA2 level was revealed; in women taking ASA, an increase in platelet membrane rigidity was found. Conclusions. The study revealed a multidirectional response of platelets to hyperbaric oxygen, associated with the presence or absence of antiaggregant therapy.

For citation: Ruzov V.I., Goryachaya M.N., Kostishko B.B. Hyperbaric oxygenation and structural and functional heterogenicity of platelet response in ischemic heart disease: focus on personalizing the effect. Tromboz, gemostaz i reologiya. 2022;(4):35–40. (In Russ.).

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