Remote ischaemic preconditioning safely and effectively induces limb ischaemia

A. Javadzadegan, J. Lau, A. Moshfegh, L. Kritharides, A. Yong

Research output: Contribution to journalMeeting abstract

Abstract

Introduction: Remote ischaemic preconditioning (RIPC) has been shown to confer cardioprotection during percutaneous coronary intervention. Remote ischaemic preconditioning is commonly delivered with a pressure cuff inflated to a suprasystolic pressure on the upper limb. There are several different devices and protocols used to achieve RIPC. The aim of this study was to assess the effectiveness and safety of a commonly used RIPC protocol.

Methods: Patients were recruited prior to their planned cardiac catheterisation and were either treated with RIPC (3 × 5 minutes 200 mmHg sphygmomanometer inflations, separated by 5 minutes of deflation) or sham (10 mmHg) on their left arm. Venous blood was taken from the left cubital fossa before and immediately after the last inflation. Blood lactate, plasma creatine kinase (CK) and plasma lactate dehydrogenase (LDH) were measured before and after RIPC or sham within 15 minutes of collection.

Results: Sixteen patients underwent paired blood sampling (10 RIPC, six sham): mean age was 60.6 ± 11.9 years, and 81% were males. Remote ischaemic preconditioning was associated with a significant increase in blood lactate (1.4 ± 0.6 mmol/L vs 1.7 ± 0.6 mmol/L, p = 0.003) without any change in CK (109.2 ± 47.1 U/L vs 105.6 ± 45.8 U/L, p = 0.11) or LDH (172.5 U/L, range 157.0–192.0 vs 183.0 U/L, range 164.5–208.3, p = 0.18). Sham treatment was not associated with any changes to suggest ischaemia or muscle injury.

Conclusions: This study demonstrates that a RIPC protocol consisting of three cycles of ischaemia and reperfusion lead to a significant rise in blood lactate without evidence of muscle injury, implying that this protocol is safe to use for clinical studies. This study provides a template with which to assess other RIPC protocols and novel devices that are being developed to perform RIPC.
Original languageEnglish
Article number0665
Pages (from-to)S342
Number of pages1
JournalHeart, Lung and Circulation
Volume27
Issue numberSupplement 2
DOIs
Publication statusPublished - 2018
Event66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting - Brisbane, Australia
Duration: 2 Aug 20185 Aug 2018

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