Regional ischemic 'preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion.

Przyklenk, Karin; Bauer, Barbara; Ovize, Michel; Kloner, Robert A.; Whittaker, Peter

doi:10.1161/01.cir.87.3.893

Cited by 1,197 publications

(832 citation statements)

References 25 publications

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“…In the early 1990s, Przyklenk et al [8] proposed the concept of remote ischemic preconditioning. In their study, brief ischemia of the remote circumflex artery provided protection to ischemic myocardium from subsequent sustained left anterior descending artery occlusion.…”

Section: Introductionmentioning

confidence: 99%

Ischemic Conditioning Is Safe and Effective for Octo- and Nonagenarians in Stroke Prevention and Treatment

et al. 2015

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Symptomatic intracranial arterial stenosis (SIAS) is very common in octo-and nonagenarians, especially in the Chinese population, and is likely the most common cause of stroke recurrence worldwide. Clinical trials demonstrate that endovascular treatment, such as stenting, may not be suitable for octogenarians with systemic diseases. Hence, less invasive methods for the octogenarian patients are urgently needed. Our previous study (unique identifier: NCT01321749) showed that repetitive bilateral arm ischemic preconditioning (BAIPC) reduced the incidence of stroke recurrence by improving cerebral perfusion (confirmed by single photon emission computed tomography and transcranial Doppler sonography) in patients younger than 80 years of age; however, the safety and effectiveness of BAIPC on stroke prevention in octo-and nonagenarians with SIAS are still unclear. The objective of this study was to evaluate the safety and effectiveness of BAIPC in reducing stroke recurrence in octo-and nonagenarian patients with SIAS. Fifty-eight patients with SIAS were enrolled in this randomized controlled prospective study for 180 consecutive days. All patients enrolled in the study received standard medical management. Patients in the BAIPC group (n=30) underwent 5 cycles consisting of bilateral arm ischemia followed by reperfusion for 5 min each twice daily. Those in the control group (n=28) underwent sham-BAIPC twice daily. Blood pressure, heart rate, local skin status, plasma myoglobin, and plasma levels of thrombotic and inflammatory markers were documented in both groups before beginning the study and for the first 30 days. Finally, the incidences of stroke recurrence and magnetic resonance imaging during the 180 days of treatment were compared. Compared with the control, BAIPC had no adverse effects on blood pressure, heart rate, local skin integrity, or plasma myoglobin, and did not induce cerebral hemorrhage in the studied cohort. BAIPC reduced plasma high sensitive C-reactive protein, interleukin-6, plasminogen activator inhibitor-1, leukocyte count, and platelet aggregation rate and elevated plasma tissue plasminogen activator (all p<0.01). In 180 days, 2 infarctions and 7 transient ischemic attacks were observed in the BAIPC group compared with 8 infarctions and 11 transient ischemic attacks in the sham BAIPC group (p<0.05). BAIPC may safely inhibit stroke recurrence, protect against brain ischemia, and ameliorate plasma biomarkers of inflammation and coagulation in octo-and nonagenarians with SIAS. A multicenter trial is ongoing.Clinical Trial Registration: www.clinicaltrials.gov, unique identifier: NCT01570231.

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Section: Introductionmentioning

confidence: 99%

Ischemic Conditioning Is Safe and Effective for Octo- and Nonagenarians in Stroke Prevention and Treatment

et al. 2015

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“…rIPC was first demonstrated in cardiac tissue in which brief episodes of myocardial ischemia and reperfusion applied to one vascular territory reduced the infarct size of the adjacent tissue that had not undergone any preconditioning. 2 rIPC has primarily been applied to the myocardium as a target organ, but subsequent studies showed that brief ischemia induced in nontarget tissue, most commonly in the limb or arm, confers protection at a remote site such as the brain, lung, kidney, intestine, or skeletal muscle. [3][4][5] rIPC causes a similar degree of tissue protection, as does IPC.…”

mentioning

confidence: 99%

Remote Ischemic Preconditioning and Renoprotection

Gassanov¹,

Nia

Caglayan³

et al. 2014

Journal of the American Society of Nephrology

122

106

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There is currently no effective prophylactic regimen available to prevent contrastinduced AKI (CI-AKI), a frequent and life-threatening complication after cardiac catheterization. Therefore, novel treatment strategies are required to decrease CI-AKI incidence and to improve clinical outcomes in these patients. Remote ischemic preconditioning (rIPC), defined as transient brief episodes of ischemia at a remote site before a subsequent prolonged ischemia/reperfusion injury of the target organ, is an adaptational response that protects against ischemic and reperfusion insult. Indeed, several studies demonstrated the tissue-protective effects of rIPC in various target organs, including the kidneys. In this regard, rIPC may offer a novel noninvasive and virtually cost-free treatment strategy for decreasing CI-AKI incidence. This review evaluates the current experimental and clinical evidence for rIPC as a potential renoprotective strategy, and discusses the underlying mechanisms and key areas for future research.

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“…In 1993, Pryzklenk and colleagues (52) made the intriguing observation that the preconditioning effect elicited by brief ischaemia in the circumfl ex artery territory could actually be manifested in myocardium supplied by the left anterior descending artery territory, indicating for the fi rst time that protection could be conveyed from one region of the heart to another. This concept has been further evolved and developed to extend to organs and tissue distant from the heart such as the kidney, small intestine, liver, and the limbs, such that brief episodes of ischaemia and reperfusion applied to these organs or tissue have been reported to protect against myocardial infarction -a phenomenon termed remote ischaemic preconditioning (RIPC) (reviewed in).…”

Section: Remote Ischaemic Preconditioning: Giving Your Right Arm To Pmentioning

confidence: 99%

Preconditioning and postconditioning: from bench to bedside

Hausenloy

Yellon

2017

SAHJ

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Regional ischemic 'preconditioning' protects remote virgin myocardium from subsequent sustained coronary occlusion.

Cited by 1,197 publications

References 25 publications

Ischemic Conditioning Is Safe and Effective for Octo- and Nonagenarians in Stroke Prevention and Treatment

Ischemic Conditioning Is Safe and Effective for Octo- and Nonagenarians in Stroke Prevention and Treatment

Remote Ischemic Preconditioning and Renoprotection

Preconditioning and postconditioning: from bench to bedside

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