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remote ischaemic preconditioning

Jerrett K Lau, Gabrielle J Pennings, Andy Yong, Leonard Kritharides
Brief, non-harmful ischaemic insults to an organ remote from the heart, remote ischaemic preconditioning (RIPC), has been proposed to confer protection to the heart against ischaemia-reperfusion injury. While most clinical trials of RIPC during coronary interventions (PCI) suggest benefit, recent large, multicentre trials in coronary artery bypass surgery suggest a lack of efficacy. Mechanistically, RIPC most likely promotes the release of circulating factors which modulate multiple cellular pathways in the heart, promoting cell survival...
December 12, 2016: Heart, Lung & Circulation
Ashok Nair, Sitara Khan, Sami Omar, Xiao-Qing Pei, Karen McNeill, Phil Chowienczyk, Andrew James Webb
AIM: To test the hypothesis that remote ischaemic preconditioning (RIPC) increases circulating endogenous local and systemic plasma [nitrite] during RIPC and ischaemia-reperfusion (IR) as a potential protective mechanism against ischaemia-reperfusion injury (IRI). METHODS: Six healthy male volunteers (mean age 29.5 ± 7.6 years) were randomised in a cross-over study to initially receive either RIPC (4 x 5 min cycles) to the left arm, or no RIPC (Control), both followed by an ischaemia-reperfusion (IR) sequence (20 min cuff inflation to 200 mmHg, 20 min reperfusion) to the right arm...
January 10, 2017: British Journal of Clinical Pharmacology
Daniel I Bromage, Jack M J Pickard, Xavier Rossello, Oliver J Ziff, Niall Burke, Derek M Yellon, Sean M Davidson
AIMS: The potential of remote ischaemic conditioning (RIC) to ameliorate myocardial ischaemia-reperfusion injury (IRI) remains controversial. We aimed to analyse the pre-clinical evidence base to ascertain the overall effect and variability of RIC in animal in vivo models of myocardial IRI. Furthermore, we aimed to investigate the impact of different study protocols on the protective utility of RIC in animal models and identify gaps in our understanding of this promising therapeutic strategy...
October 23, 2016: Cardiovascular Research
Seyed Mahmoud Nouraei, Afshin Gholipour Baradari, Asieh Jazayeri
OBJECTIVE: To investigate efficacy of remote ischaemic preconditioning on reducing kidney injury and myocardial damage after coronary artery bypass grafting surgery (CABG). BACKGROUND: Ischaemic preconditioning of a remote organ reduces ischaemia-reperfusion injury of kidney and myocardium after CABG. METHOD: To reduce myocardial damage and kidney injury by applying Remote Ischaemic Preconditioning we recruited 100 consecutive patients undergoing elective coronary artery bypass grafting surgery...
October 2016: Medical Archives
Sanjeev Kanoria, Francis P Robertson, Naimish N Mehta, Giuseppe Fusai, Dinesh Sharma, Brian R Davidson
BACKGROUND: Liver resection produces excellent long-term survival for patients with colorectal liver metastases but is associated with significant morbidity and mortality from ischaemia reperfusion injury (IRI). Remote ischaemic preconditioning (RIPC) can reduce the effect of IRI. This pilot randomised controlled trial evaluated RIPC in patients undergoing major hepatectomy at the Royal Free Hospital, London. METHODS: Sixteen patients were randomised to RIPC or sham control...
December 8, 2016: World Journal of Surgery
Shifei Wang, Hairui Li, Nvqin He, Yili Sun, Shengcun Guo, Wangjun Liao, Yulin Liao, Yanmei Chen, Jianping Bin
BACKGROUND: The impact of remote ischaemic preconditioning (RIPC) on major clinical outcomes in patients undergoing cardiovascular surgery remains controversial. We systematically reviewed the available evidence to evaluate the potential benefits of RIPC in such patients. METHODS: PubMed, Embase, and Cochrane Library databases were searched for relevant randomised controlled trials (RCTs) conducted between January 2006 and March 2016. The pooled population of patients who underwent cardiovascular surgery was divided into the RIPC and control groups...
January 15, 2017: International Journal of Cardiology
Melanie Meersch, Alexander Zarbock
Acute kidney injury is a common and serious complication with a huge impact on morbidity and short- as well as long-term mortality. Sepsis and major surgeries, especially cardiac surgery, are the most common causes of acute kidney injury. Slight increases of serum-creatinine levels are associated with adverse outcomes highlighting the relevance of the need for nephroprotective strategies to reduce the occurrence of acute kidney injury. Remote ischaemic preconditioning is an intervention consisting of brief episodes of ischaemia and reperfusion at a remote site before subsequent ischaemic insults occur...
November 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
G T C Wong, E Y P Lee, M G Irwin
Contrast induced nephropathy (CIN) is traditionally associated with outpatient imaging studies. More recently, patients afflicted with vascular pathologies are increasingly undergoing endovascular treatments that require the use of iodinated contrast media (CM) agents, thus placing them as risk of developing CIN. As perioperative physicians, anaesthetists should be aware of the risk factors and measures that might minimize acute kidney injury caused by CM. This review evaluates recent data regarding preventive measures against CIN and where possible, places the evidence in the context of the patient receiving endovascular surgical treatment...
September 2016: British Journal of Anaesthesia
Lucio Barile, Tiziano Moccetti, Eduardo Marbán, Giuseppe Vassalli
Exosomes are extracellular vesicles of endosomal origin which have emerged as key mediators of intercellular communication. All major cardiac cell types-including cardiomyocytes, endothelial cells, and fibroblasts-release exosomes that modulate cellular functions. Exosomes released from human cardiac progenitor cells (CPCs) are cardioprotective and improve cardiac function after myocardial infarction to an extent comparable with that achieved by their parent cells. Cardiac progenitor cell-derived exosomes are enriched in cardioprotective microRNAs, particularly miR-146a-3p...
July 21, 2016: European Heart Journal
Gerd Heusch, Bernard J Gersh
The incidence of ST segment elevation myocardial infarction (STEMI) has decreased over the last two decades in developed countries, but mortality from STEMI despite widespread access to reperfusion therapy is still substantial as is the development of heart failure, particularly among an expanding older population. In developing countries, the incidence of STEMI is increasing and interventional reperfusion is often not available. We here review the pathophysiology of acute myocardial infarction and reperfusion, notably the temporal and spatial evolution of ischaemic and reperfusion injury, the different modes of cell death, and the resulting coronary microvascular dysfunction...
June 26, 2016: European Heart Journal
Jürgen Peters
No abstract text is available yet for this article.
July 2016: Basic Research in Cardiology
A Zarbock, J Kellum, H Van Aken, C Schmidt, S Martens, D Görlich, M Meersch
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Annette L Mazzone, Robert A Baker, Jonathan M Gleadle
The incidence of acute kidney injury (AKI) is a frequent and serious complication of cardiac surgery. In 2013, 95% of cardiac surgical procedures performed in Australia and New Zealand used cardiopulmonary bypass (CPB). AKI following CPB is well known, yet the perioperative factors contributing to its development are incompletely understood. AKI following CPB has significant implications on both short-term and long-term outcomes. The techniques for conducting CPB have evolved, moving towards evidence-based practice; however, there is still no generally accepted definition of optimal perfusion and its conduct...
October 2016: Nephrology
Cherry X Cheung, Donagh A Healy, Stewart R Walsh
Remote ischaemic preconditioning (RIPC) is an attractive cardioprotective strategy. Although results from animal studies and phase II study on humans are convincing, it cannot have a role in clinical practice until benefits in clinical outcomes are proven in phase III study. Two phase III studies were recently published [Remote Ischemic Preconditioning for Heart Surgery (RIPHeart) and Effect of Remote Ischemic Preconditioning on Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Surgery (ERICCA)] and this article discusses their design, results and implications...
March 2016: Journal of Thoracic Disease
Francis P Robertson, Rup Goswami, Graham P Wright, Barry Fuller, Brian R Davidson
ABSTRACT: Ischaemic reperfusion (IR) injury is a major cause of graft loss, morbidity and mortality following orthotopic liver transplantation (OLT). Demand for liver transplantation has resulted in increasing use of marginal grafts that are more prone to IR injury. Remote ischaemic preconditioning (RIPC) reduces IR injury in experimental models, but recipient RIPC has not been evaluated clinically. METHODS: A single-centre double-blind randomized controlled trial (RCT) is planned to test the hypothesis that recipient RIPC will reduce IR injury...
2016: Transplantation Research
Michael M Galagudza, Dmitry L Sonin, Timur D Vlasov, Dmitry I Kurapeev, Eugene V Shlyakhto
The unmet clinical need for myocardial salvage during ischaemia-reperfusion injury requires the development of new techniques for myocardial protection. In this study the protective effect of different local ischaemic preconditioning (LIPC) and remote ischaemic preconditioning (RIPC) protocols was compared in the rat model of myocardial ischaemia-reperfusion, using infarct size and ischaemic tachyarrhythmias as end-points. In addition, the hypothesis that there is involvement of reactive oxygen species (ROS) in the protective signalling by RIPC was tested, again in comparison with LIPC...
February 2016: International Journal of Experimental Pathology
Dick H J Thijssen, Joseph Maxwell, Daniel J Green, N Timothy Cable, Helen Jones
What is the topic of this review? This review discusses the effects of repeated exposure of tissue to ischaemic preconditioning on cardiovascular function, the attendant adaptations and their potential clinical relevance. What advances does it highlight? We discuss the effects of episodic exposure to ischaemic preconditioning to prevent and/or attenuate ischaemic injury and summarize evidence pertaining to improvements in cardiovascular function and structure. Discussion is provided regarding the potential mechanisms that contribute to both local and systemic adaptation...
June 1, 2016: Experimental Physiology
Maxime Caru, François Lalonde, Hugo Gravel, Chantal Daigle, François Tournoux, Vincent Jacquemet, Daniel Curnier
UNLABELLED: The protective action of remote ischaemic preconditioning (RIPC) has been demonstrated in the context of surgical interventions in cardiology. Application of RIPC to sports performance has been proposed, but its effect on the electrocardiogram (ECG) during exercise remains unknown. This exploratory study aims to measure the changes in ventricular repolarization observed during exercise following RIPC in healthy subjects. In an experimental randomized crossover study, 17 subjects underwent two bouts of constant load exercise tests at 75% and 115% of gas exchange threshold (GET)...
November 2016: European Journal of Sport Science
Yingbiao Wu, Xiaojian Hong, Aihua Wang, Dan Wei, Xuhong Wang, Keji Liang, Junjie Kou
BACKGROUND: The aim is to compare effects of three different protocols of limb remote ischaemic preconditioning (LRIP) on ischaemia reperfusion injury in an acute left anterior descending artery (LAD) occlusion model rat. METHODS: Forty adult male Wistar rats were randomly assigned into four groups: group A, control; group B, LRIP in bilateral upper-limb (BUL) IP; group C, LRIP in bilateral lower-limb (BLL) IP; group D, LRIP in bilateral upper and lower limbs (ULL) IP...
July 2016: Heart, Lung & Circulation
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