Remote ischaemic preconditioning – translating cardiovascular benefits to humans

Lang, J.; Kim, Jahyun

doi:10.1113/jp282568

Cited by 24 publications

(14 citation statements)

References 94 publications

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“…The protective effects of IPC are reputed to involve humoral, neural, and systemic triggers that initiate a cascade of physiological responses that render tissues more tolerant to subsequent ischemia ( Hausenloy and Yellon, 2008 ). The downstream biochemical pathways purportedly responsible for the protective effects of IPC are complex and have been reviewed previously ( Heusch et al, 2015 ; Kleinbongard et al, 2017 ; Lang et al, 2022 ). Presently, it is not known how or if these protective biochemical pathways interact with exercise to promote performance enhancement, or whether the ergogenic effects involve distinctly different physiological responses.…”

Section: Potential Mechanisms For Ipc-induced Ergogenicitymentioning

confidence: 99%

Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

O’Brien

Jacobs

2022

Front. Physiol.

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Ischemic preconditioning (IPC) has been reported to augment exercise performance, but there is considerable heterogeneity in the magnitude and frequency of performance improvements. Despite a burgeoning interest in IPC as an ergogenic aid, much is still unknown about the physiological mechanisms that mediate the observed performance enhancing effects. This narrative review collates those physiological responses to IPC reported in the IPC literature and discusses how these responses may contribute to the ergogenic effects of IPC. Specifically, this review discusses documented central and peripheral cardiovascular responses, as well as selected metabolic, neurological, and perceptual effects of IPC that have been reported in the literature.

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Section: Potential Mechanisms For Ipc-induced Ergogenicitymentioning

confidence: 99%

Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

O’Brien

Jacobs

2022

Front. Physiol.

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“…Briefly, remote ischemic preconditioning (rIPC) involves inducing non‐lethal stress on organs distant from the organ undergoing ischemia–reperfusion injury (IRI) through intermittently blocking the blood flow of limbs and finally leads the systemic and local tolerance to subsequent IRI, 4 which has been reported to be efficient in improving local and systemic endothelial function assessed by flow‐mediated dilation (FMD) and micro‐circulation in healthy, young, adult males, 5 which has not ever been examined on people with CKD. Patients with CKD usually experience repressed exercise endurance to be unable to engage in moderate‐ to high‐intensity exercise 6 .…”

Section: Introductionmentioning

confidence: 99%

“…3 By understanding the underlying molecular mechanisms under endothelial damage insult, the use of endothelial-protective therapeutic measures are beneficial to balance the immune microenvironment in patients with CKD, thereby improving vascular endothelial function and reducing the risk of death resulted from cardiovascular complications in CKD patients. 3 Briefly, remote ischemic preconditioning (rIPC) involves inducing non-lethal stress on organs distant from the organ undergoing ischemia-reperfusion injury (IRI) through intermittently blocking the blood flow of limbs and finally leads the systemic and local tolerance to subsequent IRI, 4 which has been reported to be efficient in improving local and systemic endothelial function assessed by flow-mediated dilation (FMD) and micro-circulation in healthy, young, adult males, 5 which has not ever been examined on people with CKD. Patients with CKD usually experience repressed exercise endurance to be unable to engage in moderate-to high-intensity exercise.…”

Section: Introductionmentioning

confidence: 99%

The effect of short‐term remote ischemic preconditioning on endothelial function of patients with chronic kidney disease: A randomized pilot study

Xu,

Zhang,

Chen

et al. 2024

Nephrology

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AimPatients with chronic kidney disease (CKD) are more susceptible to endothelial dysfunction and cardiovascular disease (CV). Remote ischemic preconditioning (rIPC) has been proven efficient in improving endothelial function and lowering the risk of CV. However, the safety and effect of rIPC on endothelial function in patients with CKD have not been effectively assessed.Methods45 patients with CKD (average estimated glomerular filtration rate: 48.4 mL/min/1.73 m2) were randomly allocated to either 7‐day daily upper‐arm rIPC (4 × 5 min 200 mmHg, interspaced by 5‐min reperfusion) or control (4 × 5 min 60 mmHg, interspaced by 5‐min reperfusion). Vascular endothelial function was assessed by natural log–transformed reactive hyperemia index (LnRHI) before and after a 7‐day intervention. Arterial elasticity was assessed by augmentation index (AI).ResultsThe results showed that LnRHI could be improved by rIPC treatment (Pre = 0.57 ± 0.04 vs. Post = 0.67 ± 0.04, p = .001) with no changes relative to control (Pre = 0.68 ± 0.06 vs. Post = 0.64 ± 0.05, p = .470). Compared with the control group, the improvement of LnRHI was greater after rIPC treatment (rIPC vs. Control: 0.10 ± 0.03 vs. −0.04 ± 0.06, between‐group mean difference, −0.15 [95% CI, −0.27 to −0.02], p = .027), while there was no significant difference in the change of AI@75 bpm (p = .312) between the two groups.ConclusionRIPC is safe and well tolerated in patients with CKD. This pilot study suggests that rIPC seems to have the potential therapeutic effect to improve endothelial function. Of note, further larger trials are still warranted to confirm the efficacy of rIPC in improving endothelial function in CKD patients.image

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“…In turn these responses activate intracellular signal transduction pathways such as the protein kinase C pathway and the reperfusion injury salvage kinase pathway. The preservation of mitochondrial functions and gene expression modulation are thought to be central mechanisms in the systemic effects of RIPC [ 31 ]. We hypothesised that RIPC stabilises the function of the endothelium during surgical stress of non-cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of Remote Ischaemic Preconditioning on Perioperative Endothelial Dysfunction in Non-Cardiac Surgery: A Randomised Clinical Trial

Wahlstrøm

Hansen

Kvist

et al. 2023

Cells

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Endothelial dysfunction result from inflammation and excessive production of reactive oxygen species as part of the surgical stress response. Remote ischemic preconditioning (RIPC) potentially exerts anti-oxidative and anti-inflammatory properties, which might stabilise the endothelial function after non-cardiac surgery. This was a single centre randomised clinical trial including 60 patients undergoing sub-acute laparoscopic cholecystectomy due to acute cholecystitis. Patients were randomised to RIPC or control. The RIPC procedure consisted of four cycles of five minutes of ischaemia and reperfusion of one upper extremity. Endothelial function was assessed as the reactive hyperaemia index (RHI) and circulating biomarkers of nitric oxide (NO) bioavailability (L-arginine, asymmetric dimethylarginine (ADMA), L-arginine/ADMA ratio, tetra- and dihydrobiopterin (BH4 and BH2), and total plasma biopterin) preoperative, 2–4 h after surgery and 24 h after surgery. RHI did not differ between the groups (p = 0.07). Neither did levels of circulating biomarkers of NO bioavailability change in response to RIPC. L-arginine and L-arginine/ADMA ratio was suppressed preoperatively and increased 24 h after surgery (p < 0.001). The BH4/BH2-ratio had a high preoperative level, decreased 2–4 h after surgery and remained low 24 h after surgery (p = 0.01). RIPC did not influence endothelial function or markers of NO bioavailability until 24 h after sub-acute laparoscopic cholecystectomy. In response to surgery, markers of NO bioavailability increased, and oxidative stress decreased. These findings support that a minimally invasive removal of the inflamed gallbladder countereffects reduced markers of NO bioavailability and increased oxidative stress caused by acute cholecystitis.

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Remote ischaemic preconditioning – translating cardiovascular benefits to humans

Abstract: support-information-section).

Cited by 24 publications

References 94 publications

Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

The effect of short‐term remote ischemic preconditioning on endothelial function of patients with chronic kidney disease: A randomized pilot study

Effect of Remote Ischaemic Preconditioning on Perioperative Endothelial Dysfunction in Non-Cardiac Surgery: A Randomised Clinical Trial

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