Ischemic preconditioning

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VentdependenT

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Remote ischaemic preconditioning reduces myocardial injury in patients undergoing heart valve surgery: randomised controlled trial.

AuthorsXie JJ, et al. Show all Journal
Heart. 2012 Mar;98(5):384-8. doi: 10.1136/heartjnl-2011-300860. Epub 2011 Nov 22.

Affiliation
Surgery/Cardiothoracic, Guangzhou First Municipal People's Hospital, Guangzhou Institute of Clinical Medicine, Guangzhou Medical College, Guangzhou, PR China.

Abstract
OBJECTIVE: To determine whether remote ischaemic preconditioning (RIPC) is cardioprotective in patients undergoing heart valve replacement.

DESIGN: Single-blinded, randomised controlled trial.

SETTING: Tertiary referral hospital in China.

PATIENTS: Adult patients (31-72 years) undergoing mitral valve, aortic valve or tricuspid valve surgery.

INTERVENTIONS: Patients were randomised to either the RIPC (n=38) or control (n=35) group. After induction of anaesthesia, patients in the RIPC group underwent three 5 min cycles of right upper limb ischaemia, induced by an automated cuff-inflator placed on the upper arm and inflated to 200 mm Hg. Each cycle was interrupted by a 5 min period of reperfusion during which time the cuff was deflated. The control group had only a deflated cuff placed on the upper arm for 30 min.

MAIN OUTCOME MEASURES: Serum troponin I concentration was measured before surgery and at 6, 12, 24, 48, and 72 h postoperatively. The cardiac function of all patients was followed postoperatively.

RESULTS: Troponin I concentration was reduced in the RIPC group (398.7±179.3 &#956;g/l) compared with the control group (708.4±242.5 &#956;g/l). Mean difference was 309.7±50.8 (95% CI 210.1 to 409.3, p<0.0001). A greater improvement in postsurgical cardiac function was noted in the RIPC group than in the control group.

CONCLUSIONS: These data indicate that RIPC reduces myocardial injury and improves cardiac function in patients undergoing heart valve surgery.

TRIAL REGISTRATION NUMBER: NCT01175681.

PMID 22107759 [PubMed - indexed for MEDLINE]



Soooo...anyone trying this stuff out. May have further benefits if done multiple times in the preoperative period and perhaps extended to all high RCRI (revised cardiac risk index) patients...

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