Skip to main content
Top
Published in: Irish Journal of Medical Science (1971 -) 4/2017

01-11-2017 | Original Article

Effects of remote ischemic preconditioning on acute myocardial injury in patients undergoing valve replacement

Authors: Z. Cao, R. Shen, X. Zhang, G. Cheng, Z. Yan

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2017

Login to get access

Abstract

Background

This study investigated the effects of remote ischemic preconditioning (RIPC) on acute myocardial injury and clinical outcome in adult patients undergoing valve replacement surgery.

Methods

Sixty-three adult patients scheduled for elective valve replacement undergoing cardiopulmonary bypass (CPB) were randomly assigned to control or remote ischemic preconditioning treatment. RIPC was applied beginning with the first surgical incision by three times of inflating the cuff to 200 mmHg for 5 min, followed by 5 min of deflation. The plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) were determined. The preoperative, intraoperative, and postoperative characteristics, and hemodynamics values were recorded during the study.

Results

There were no significant differences in patient preoperative, intraoperative, and postoperative characteristics and hemodynamics values between groups. The activity of CK-MB and cTnI was significantly lower in RIPC group than CON group at 4 and 48 h after aortic unclamping.

Conclusions

The present study demonstrated that remote ischemic preconditioning might reduce release of CK-MB and cTnI in patients undergoing valve replacement. However, RIPC does not improve the clinical outcome of these patients.
Literature
1.
go back to reference Lacour-Gayet F, Clarke D, Jacobs J et al (2004) The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 25(6):911–924CrossRefPubMed Lacour-Gayet F, Clarke D, Jacobs J et al (2004) The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 25(6):911–924CrossRefPubMed
2.
go back to reference Murry CE, Jennings RB, Reimer KA (1986) Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 74(5):1124–1136CrossRefPubMed Murry CE, Jennings RB, Reimer KA (1986) Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Circulation 74(5):1124–1136CrossRefPubMed
3.
go back to reference Schultz JJ, Hsu AK, Gross GJ (1996) Morphine mimics the cardioprotective effect of ischemic preconditioning via a glibenclamide-sensitive mechanism in the rat heart. Circ Res 78(6):1100–1104CrossRefPubMed Schultz JJ, Hsu AK, Gross GJ (1996) Morphine mimics the cardioprotective effect of ischemic preconditioning via a glibenclamide-sensitive mechanism in the rat heart. Circ Res 78(6):1100–1104CrossRefPubMed
4.
go back to reference Ludwig LM, Patel HH, Gross GJ et al (2003) Morphine enhances pharmacological preconditioning by isoflurane: role of mitochondrial K(ATP) channels and opioid receptors. Anesthesiology 98(3):705–711CrossRefPubMed Ludwig LM, Patel HH, Gross GJ et al (2003) Morphine enhances pharmacological preconditioning by isoflurane: role of mitochondrial K(ATP) channels and opioid receptors. Anesthesiology 98(3):705–711CrossRefPubMed
5.
go back to reference Henn MC, Janjua MB, Kanter EM et al (2015) Adenosine triphosphate-sensitive potassium channel kir subunits implicated in cardioprotection by diazoxide. J Am Heart Assoc 4(8):e002016CrossRefPubMedPubMedCentral Henn MC, Janjua MB, Kanter EM et al (2015) Adenosine triphosphate-sensitive potassium channel kir subunits implicated in cardioprotection by diazoxide. J Am Heart Assoc 4(8):e002016CrossRefPubMedPubMedCentral
6.
go back to reference Yamazaki KG, Taub PR, Barraza-Hidalgo M et al (2010) Effects of (−)-epicatechin on myocardial infarct size and left ventricular remodeling after permanent coronary occlusion. J Am Coll Cardiol 55(25):2869–2876CrossRefPubMedPubMedCentral Yamazaki KG, Taub PR, Barraza-Hidalgo M et al (2010) Effects of (−)-epicatechin on myocardial infarct size and left ventricular remodeling after permanent coronary occlusion. J Am Coll Cardiol 55(25):2869–2876CrossRefPubMedPubMedCentral
7.
go back to reference Przyklenk K, Bauer B, Ovize M, Kloner RA, Whittaker P (1993) Regional ischemic “preconditioning” protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation 87(3):893–899CrossRefPubMed Przyklenk K, Bauer B, Ovize M, Kloner RA, Whittaker P (1993) Regional ischemic “preconditioning” protects remote virgin myocardium from subsequent sustained coronary occlusion. Circulation 87(3):893–899CrossRefPubMed
8.
go back to reference Patel HH, Moore J, Hsu AK, Gross GJ (2002) Cardioprotection at a distance: mesenteric artery occlusion protects the myocardium via an opioid sensitive mechanism. J Mol Cell Cardiol 34(10):1317–1323CrossRefPubMed Patel HH, Moore J, Hsu AK, Gross GJ (2002) Cardioprotection at a distance: mesenteric artery occlusion protects the myocardium via an opioid sensitive mechanism. J Mol Cell Cardiol 34(10):1317–1323CrossRefPubMed
9.
go back to reference Hausenloy DJ, Mwamure PK, Venugopal V et al (2007) Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial. Lancet 370(9587):575–579CrossRefPubMed Hausenloy DJ, Mwamure PK, Venugopal V et al (2007) Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial. Lancet 370(9587):575–579CrossRefPubMed
10.
go back to reference Venugopal V, Hausenloy DJ, Ludman A et al (2009) Remote ischaemic preconditioning reduces myocardial injury in patients undergoing cardiac surgery with cold-blood cardioplegia: a randomised controlled trial. Heart 95(19):1567–1571CrossRefPubMed Venugopal V, Hausenloy DJ, Ludman A et al (2009) Remote ischaemic preconditioning reduces myocardial injury in patients undergoing cardiac surgery with cold-blood cardioplegia: a randomised controlled trial. Heart 95(19):1567–1571CrossRefPubMed
11.
go back to reference Xie JJ, Liao XL, Chen WG et al (2012) Remote ischaemic preconditioning reduces myocardial injury in patients undergoing heart valve surgery: randomised controlled trial. Heart 98(5):384–388CrossRefPubMed Xie JJ, Liao XL, Chen WG et al (2012) Remote ischaemic preconditioning reduces myocardial injury in patients undergoing heart valve surgery: randomised controlled trial. Heart 98(5):384–388CrossRefPubMed
12.
go back to reference Li L, Luo W, Huang L et al (2010) Remote perconditioning reduces myocardial injury in adult valve replacement: a randomized controlled trial. J Surg Res 164(1):e21–e26CrossRefPubMed Li L, Luo W, Huang L et al (2010) Remote perconditioning reduces myocardial injury in adult valve replacement: a randomized controlled trial. J Surg Res 164(1):e21–e26CrossRefPubMed
13.
go back to reference Arvola O, Haapanen H, Herajärvi J et al (2016) Remote ischemic preconditioning attenuates oxidative stress during cardiopulmonary bypass. Heart Surg Forum 19(4):E192–E197CrossRefPubMed Arvola O, Haapanen H, Herajärvi J et al (2016) Remote ischemic preconditioning attenuates oxidative stress during cardiopulmonary bypass. Heart Surg Forum 19(4):E192–E197CrossRefPubMed
14.
go back to reference Meybohm P, Bein B, Brosteanu O et al (2015) A multicenter trial of remote ischemic preconditioning for heart surgery. N Engl J Med 373(15):1397–1407CrossRefPubMed Meybohm P, Bein B, Brosteanu O et al (2015) A multicenter trial of remote ischemic preconditioning for heart surgery. N Engl J Med 373(15):1397–1407CrossRefPubMed
15.
go back to reference Hausenloy DJ, Candilio L, Evans R et al (2015) Remote ischemic preconditioning and outcomes of cardiac surgery. N Engl J Med 373(15):1408–1417CrossRefPubMed Hausenloy DJ, Candilio L, Evans R et al (2015) Remote ischemic preconditioning and outcomes of cardiac surgery. N Engl J Med 373(15):1408–1417CrossRefPubMed
16.
17.
go back to reference Rentoukas I, Giannopoulos G, Kaoukis A et al (2010) Cardioprotective role of remote ischemic preconditioning in primary percutaneous coronary intervention: enhancement by opioid action. JACC Cardiovasc Interv 3(1):49–55CrossRefPubMed Rentoukas I, Giannopoulos G, Kaoukis A et al (2010) Cardioprotective role of remote ischemic preconditioning in primary percutaneous coronary intervention: enhancement by opioid action. JACC Cardiovasc Interv 3(1):49–55CrossRefPubMed
18.
go back to reference Takaoka A, Nakae I, Mitsunami K et al (1999) Renal ischemia/reperfusion remotely improves myocardial energy metabolism during myocardial ischemia via adenosine receptors in rabbits: effects of “remote preconditioning”. J Am Coll Cardiol 33(2):556–564CrossRefPubMed Takaoka A, Nakae I, Mitsunami K et al (1999) Renal ischemia/reperfusion remotely improves myocardial energy metabolism during myocardial ischemia via adenosine receptors in rabbits: effects of “remote preconditioning”. J Am Coll Cardiol 33(2):556–564CrossRefPubMed
19.
go back to reference Johnsen J, Pryds K, Salman R et al (2016) The remote ischemic preconditioning algorithm: effect of number of cycles, cycle duration and effector organ mass on efficacy of protection. Basic Res Cardiol 111(2):10CrossRefPubMed Johnsen J, Pryds K, Salman R et al (2016) The remote ischemic preconditioning algorithm: effect of number of cycles, cycle duration and effector organ mass on efficacy of protection. Basic Res Cardiol 111(2):10CrossRefPubMed
20.
go back to reference Skyschally A, Gent S, Amanakis G et al (2015) Across-species transfer of protection by remote ischemic preconditioning with species-specific myocardial signal transduction by reperfusion injury salvage kinase and survival activating factor enhancement pathways. Circ Res 117(3):279–288CrossRefPubMed Skyschally A, Gent S, Amanakis G et al (2015) Across-species transfer of protection by remote ischemic preconditioning with species-specific myocardial signal transduction by reperfusion injury salvage kinase and survival activating factor enhancement pathways. Circ Res 117(3):279–288CrossRefPubMed
21.
go back to reference Landoni G, Greco T, Biondi-Zoccai G et al (2013) Anaesthetic drugs and survival: a Bayesian network meta-analysis of randomized trials in cardiac surgery. Br J Anaesth 111(6):886–896CrossRefPubMed Landoni G, Greco T, Biondi-Zoccai G et al (2013) Anaesthetic drugs and survival: a Bayesian network meta-analysis of randomized trials in cardiac surgery. Br J Anaesth 111(6):886–896CrossRefPubMed
22.
go back to reference Kottenberg E, Thielmann M, Bergmann L et al (2012) Protection by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol—a clinical trial. Acta Anaesthesiol Scand 56(1):30–38CrossRefPubMed Kottenberg E, Thielmann M, Bergmann L et al (2012) Protection by remote ischemic preconditioning during coronary artery bypass graft surgery with isoflurane but not propofol—a clinical trial. Acta Anaesthesiol Scand 56(1):30–38CrossRefPubMed
23.
go back to reference Hausenloy DJ, Candilio L, Yellon DM (2016) Remote ischemic preconditioning and cardiac surgery. N Engl J Med 374:491–492PubMed Hausenloy DJ, Candilio L, Yellon DM (2016) Remote ischemic preconditioning and cardiac surgery. N Engl J Med 374:491–492PubMed
24.
go back to reference Pinaud F, Corbeau JJ, Baufreton C et al (2016) Remote ischemic preconditioning in aortic valve surgery: results of a randomized controlled study. J Cardiol 67(1):36–41CrossRefPubMed Pinaud F, Corbeau JJ, Baufreton C et al (2016) Remote ischemic preconditioning in aortic valve surgery: results of a randomized controlled study. J Cardiol 67(1):36–41CrossRefPubMed
25.
go back to reference Hu Q, Luo W, Huang L et al (2016) Multiorgan protection of remote ischemic perconditioning in valve replacement surgery. J Surg Res 200(1):13–20CrossRefPubMed Hu Q, Luo W, Huang L et al (2016) Multiorgan protection of remote ischemic perconditioning in valve replacement surgery. J Surg Res 200(1):13–20CrossRefPubMed
Metadata
Title
Effects of remote ischemic preconditioning on acute myocardial injury in patients undergoing valve replacement
Authors
Z. Cao
R. Shen
X. Zhang
G. Cheng
Z. Yan
Publication date
01-11-2017
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2017
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1521-8

Other articles of this Issue 4/2017

Irish Journal of Medical Science (1971 -) 4/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.