Neuro-autonomic changes induced by remote ischemic preconditioning (RIPC) in healthy young adults: Implications for stress

Abstract

The mechanisms underlying the protective effects of remote ischemic preconditioning (RIPC) are not presently clear. Recent studies in experimental models suggest the involvement of the autonomic nervous system (ANS) in cardioprotection. The aim of this study was to investigate the changes in ANS in healthy young volunteers divided into RIPC (n = 22) or SHAM (n = 18) groups. RIPC was induced by 1 cycle of 4 min inflation/5 min deflation followed by 2 cycles of 5 min inflation/5 min deflation of a cuff placed on the upper left limb. The study included analysis of heart rate (HR), blood pressure (BP), heart rate variability (HRV), measurements of microcirculation and porphyrin fluorescence in the limb before and after the RIPC. RIPC caused reactive hyperemia in the limb and reduced blood porphyrin level. A mental load (serial sevens test) and mild motor stress (hyperventilation) were performed on all subjects before and after RIPC or corresponding rest in the SHAM group. Reduction of HR occurred during the experiments in both RIPC and SHAM groups reflecting RIPC-independent adaptation of the subjects to the experimental procedure. However, in contrast to the SHAM group, RIPC altered several of the spectral indices of HRV during the serial sevens test and hyperventilation. This was expressed predominantly as an increase in power of the very low-frequency band of the spectrum, increased values of detrended fluctuation analysis and weakening of correlation between the HRV parameters and HR. In conclusion, RIPC induces changes in the activity of ANS that are linked to stress resistance.

Remote Ischemic Preconditioning to Prevent Acute Kidney Injury After Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials

“…The potential mechanisms underlying the preventative role of RIPC on AKI after cardiac surgery are likely multifactorial ( 8 , 9 ). Generally, RIPC is considered to mediate organ protection via regulating both the sympathetic and parasympathetic components of the autonomic nervous system ( 46 – 48 ). Ischemia has been associated with activation of sensory (afferent) C-fiber neurons, which trigger the vagus nerve of a distant organ, such as the kidney, consequently exerting protective effects ( 49 ).…”

Two weeks of remote ischaemic preconditioning alters sympathovagal balance in healthy humans

“…Many of the studies that have examined the effects of RIPC in humans have generally done so after implementing only a single RIPC session (Sabino‐Carvalho et al., 2019). No differences in HRV were observed immediately following a single bout of RIPC (Khaliulin et al., 2019; Zagidullin et al., 2016). However, during the final ischaemia period of RIPC, there was an increase in the high frequency domain (Enko et al., 2011), and RIPC blunted the increase in sympathetic activity that occurred during 20 min of ischaemic injury (Lambert et al., 2016).…”

“…An indirect method to assess vagal activity is via heart rate variability (HRV). After a single bout of RIPC, there is no apparent change in the spectral assessment of HRV (Khaliulin et al., 2019; Zagidullin, Scherbakova, Safina, Zulkarneev, & Zagidullin, 2016). However, these findings may be affected by the proximity of the HRV measurements relative to when RIPC occurred, since RIPC yields two windows of protection against IR injury.…”

Chronic Limb Remote Ischemic Conditioning may have an Antihypertensive Effect in Patients with Hypertension

“…Second, different LRIC schemes were used. LRIC therapy for once or twice only was performed in 10 studies [ 21 - 23 , 25 - 27 , 30 - 33 ], a long-term repeated LRIC therapy was applied in 12 studies [ 11 - 16 , 18 - 20 , 24 , 28 , 29 ]. Thus, we classified these relevant articles according to different participant selection and LRIC schemes to clarify whether LRIC has an antihypertensive effect in specific populations, the details of these studies are listed in Table 1 and 2 .…”