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remote ischaemic preconditioning

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...
November 17, 2016: 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
B Cunniffe, V Sharma, M Cardinale, D Yellon
Remote ischaemic preconditioning is a non-invasive intervention with potential to protect a number of organs against ischaemia-reperfusion injury and possibly improve athletic performance. Little mechanistic evidence exists to support either limb choice or cuff inflation pressure that is most effective. This preliminary study aimed to establish the dose-response effect of different occlusion pressures on skeletal muscle oxygenation and blood flow in healthy males (n = 6). In a randomized controlled crossover study, cuff inflation pressures (140,160 and 180 mmHg) were used to induce limb ischaemia (× 3 cycles of 5-min) in upper (UL) and lower (LL) limbs on three separate occasions...
March 2, 2016: Clinical Physiology and Functional Imaging
Svetlana Mastitskaya, Marina Basalay, Patrick S Hosford, Andrew G Ramage, Andrey Gourine, Alexander V Gourine
Signalling pathways underlying the phenomenon of remote ischaemic preconditioning (RPc) cardioprotection are not completely understood. The existing evidence agrees that intact sensory innervation of the remote tissue/organ is required for the release into the systemic circulation of preconditioning factor(s) capable of protecting a transplanted or isolated heart. However, the source and molecular identities of these factors remain unknown. Since the efficacy of RPc cardioprotection is critically dependent upon vagal activity and muscarinic mechanisms, we hypothesized that the humoral RPc factor is produced by the internal organ(s), which receive rich parasympathetic innervation...
2016: PloS One
L A Orci, S Lacotte, G Oldani, F Slits, C De Vito, L A Crowe, L Rubbia-Brandt, J-P Vallée, P Morel, C Toso
BACKGROUND: Livers with parenchymal abnormalities tolerate ischaemia-reperfusion (IR) injury poorly. IR injury is a risk factor for hepatocellular carcinoma (HCC) recurrence. This study assessed the link between liver parenchymal abnormalities and HCC recurrence, and evaluated the protective effect of ischaemic preconditioning. METHODS: C57BL/6 mice were fed a choline-deficient diet for 6 and 12 weeks, or standard chow. Hepatic IR and ischaemic preconditioning were achieved by clamping liver blood inflow...
March 2016: British Journal of Surgery
M E Gaunt
No abstract text is available yet for this article.
March 2016: British Journal of Surgery
Derek J Hausenloy, Derek M Yellon
The 30-year anniversary of the discovery of 'ischaemic preconditioning' is in 2016. This endogenous phenomenon can paradoxically protect the heart from acute myocardial infarction by subjecting it to one or more brief cycles of ischaemia and reperfusion. Apart from complete reperfusion, this method is the most powerful intervention known for reducing infarct size. The concept of ischaemic preconditioning has evolved into 'ischaemic conditioning', a term that encompasses a number of related endogenous cardioprotective strategies, applied either directly to the heart (ischaemic preconditioning or postconditioning) or from afar, for example a limb (remote ischaemic preconditioning, perconditioning, or postconditioning)...
April 2016: Nature Reviews. Cardiology
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