Intermittent hypoxia reduces infarct size in rats with acute myocardial infarction: a systematic review and meta-analysis

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.

Intermittent hypoxia enhances the expression of hypoxia inducible factor HIF1A through histone demethylation

“…Our results are intriguing when viewed in light of studies that focus on the ‘preconditioning effects’ of sleep apnea and cardiovascular disease. Intermittent hypoxia from mild to moderate sleep apnea has been suggested to have a protective effect against myocardial infarction in both humans and animal models ( 25 , 26 , 27 , 28 , 29 , 30 ). Sleep apnea patients have higher levels of serum erythropoietin (EPO) during acute myocardial infarction ( 31 ), and EPO expression is largely controlled by HIF ( 32 ), indicating that sleep apnea may increase HIF activation.…”

Intermittent hypoxia enhances the expression of HIF1A by increasing the quantity and catalytic activity of KDM4A-C and demethylating H3K9me3 at the HIF1A locus

“…These results are particularly intriguing when viewed in light of epidemiological, clinical and animal studies that focus on the 'pre-conditioning effects' of sleep apnea and cardiovascular disease. Mild to moderate sleep apnea has been suggested to have a protective effect against myocardial infarction in humans and animal models with lower mortality, improved outcomes and reduced infarct size (Gupta et al, 2017;Hu et al, 2020;Mohananey et al, 2017;N. Shah et al, 2013;N.…”

Chronic intermittent hypoxia‐induced cardiovascular and renal dysfunction: from adaptation to maladaptation

“…Recent meta-analysis of studies performed in rodents reported that, as observed in OSA patients, CIH induces cardiac remodelling (i.e. LV hypertrophy, LV dilatation, interstitial fibrosis and apoptosis), associated or not with contractile dysfunction, as well as a dichotomous response to myocardial ischaemia and reperfusion, with both an increase and a decrease in infarct size (Belaidi et al, 2022;Hu et al, 2020). This…”

“…Recent meta‐analysis of studies performed in rodents reported that, as observed in OSA patients, CIH induces cardiac remodelling (i.e. LV hypertrophy, LV dilatation, interstitial fibrosis and apoptosis), associated or not with contractile dysfunction, as well as a dichotomous response to myocardial ischaemia and reperfusion, with both an increase and a decrease in infarct size (Belaidi et al., 2022; Hu et al., 2020). This divergent effect of CIH on myocardium could rely on several factors, such as species (Yin et al., 2012), age (Castro‐Grattoni et al., 2020, 2021; Wei et al., 2022) or the presence of comorbidities (Détrait et al., 2021; Rodriguez et al., 2014).…”