{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:39:06Z","timestamp":1788295146900,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,8,14]]},"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective\u00a0<\/jats:title>\n                  <jats:p>Hydrogen excretion is thought to be related to systemic antioxidation activity. H<jats:sub>2<\/jats:sub> selectively reduces the hydroxyl radical of free hydrogen (\u00b7OH), a highly cytotoxic form of reactive oxygen species, in cultured cells.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We investigated whether exhaled H<jats:sub>2<\/jats:sub> decreased during night sleep, reflected \u00b7OH production and was associated with heart failure severity. We enrolled 108 patients with chronic heart failure (CHF) and 15 control participants without CHF. H<jats:sub>2<\/jats:sub> concentration was measured by gas chromatography in exhaled breath collected before sleep and in the morning after overnight fasting. Overnight change in H<jats:sub>2<\/jats:sub> concentration (\u0394H<jats:sub>2<\/jats:sub>) was calculated. Mitochondrial morphology evaluated by transmission electron microscopy in endomyocardial biopsies collected from 18 patients with dilated cardiomyopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\u0394H<jats:sub>2<\/jats:sub> was significantly lower in patients with CHF compared with controls (\u22124.3\u00b11.0 vs 2.0\u00b12.1\u2009ppm, p=0.030) and was positively correlated with cardiac index (CI; r = \u22120.285, p=0.003). Patients with a \u0394H<jats:sub>2<\/jats:sub>&lt;0\u2009ppm had a significantly lower CI compared with those who had a \u0394H<jats:sub>2<\/jats:sub>&gt;0\u2009ppm (2.85\u00b10.61 vs 3.24\u00b10.65\u2009L\/min\/m<jats:sup>2<\/jats:sup>, p=0.005). \u0394H<jats:sub>2<\/jats:sub> was negatively correlated with both the percentage of vacuole-containing mitochondria and indices of cristae remodelling (r = \u22120.61, p=0.007).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Decrease in exhaled H<jats:sub>2<\/jats:sub> during night sleep was associated with CHF severity. \u0394H<jats:sub>2<\/jats:sub> warrants investigation as marker of CHF severity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2018-000814","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T10:45:34Z","timestamp":1536749134000},"page":"e000814","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Decrease in exhaled hydrogen as marker of congestive heart failure"],"prefix":"10.1136","volume":"5","author":[{"given":"Atsushi","family":"Shibata","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Sugano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan"},{"name":"Division of Cardiovascular Medicine, Keiyu Hospital, Yokohama, 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Kanzaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Ohta-Ogo","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Aiba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Kusano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikiyasu","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Cardiac Physiology, National Cerebral and Cardiovascular Center, Suita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatsue","family":"Ishibashi-Ueda","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cerebral and Cardiovascular Center, Suita, 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