AUTHOR=Wang Huilin , Lyu Yi , Liao Qingwu , Jin Lin , Xu Liying , Hu Yan , Yu Ying , Guo Kefang 

TITLE=Effects of Remote Ischemic Preconditioning in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

JOURNAL=Frontiers in Physiology

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00495

DOI=10.3389/fphys.2019.00495

ISSN=1664-042X

ABSTRACT=<sec><title>Purpose</title><p>This study aimed to evaluate effects of remote ischemic preconditioning (RIPC) on myocardial injury in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG).</p></sec><sec><title>Methods</title><p>Sixty-five patients scheduled for the OPCABG were randomly assigned to control (<italic>n</italic> = 32) or RIPC group (<italic>n</italic> = 33). All patients received general anesthesia. Before the surgical incision, RIPC was induced on an upper limb with repeated 5-min ischemia and 5-min reperfusion for four times. Blood samples were collected from right internal jugular vein. Plasma levels of IL-6, IL-8, IL-10, TNF-α, cTnT, HFABP, IMA, and MDA were detected at pre-operatively and 0, 6, 18, 24, 48, 72, and 120 h after the surgery. Left internal mammary artery (LIMA) and great saphenous vein (GSV) was cut into 2–3 mm for Western blot analysis of Hif-1α.</p></sec><sec><title>Results</title><p>In the present study, RIPC treatment significantly reduced plasma levels of cardiac troponin T (<italic>p</italic> &lt; 0.05), heart-type fatty acid binding protein (<italic>p</italic> &lt; 0.05), ischemia modified albumin (<italic>p</italic> &lt; 0.05), malondialdehyde (<italic>p</italic> &lt; 0.05), as well as plasma levels of pro-inflammatory cytokines including IL-6, IL-8, and TNF-α (<italic>P</italic> &lt; 0.05, respectively). RIPC treatment significantly increased hypoxia-inducible factor-1α (<italic>p</italic> &lt; 0.05) expression as well. Mechanical ventilation time for postoperative patients was shortened in RIPC group than those in control group (17.4 ± 3.8 h vs. 19.7 ± 2.9 h, respectively, <italic>p</italic> &lt; 0.05).</p></sec><sec><title>Conclusion</title><p>RIPC by upper limb ischemia shortens mechanical ventilation time in patients undergoing OPCABG. RIPC treatment reduces postoperative myocardial enzyme expression and pro-inflammatory cytokine production. RIPC is a protective therapeutic approach in the coronary artery bypass graft surgery.</p></sec>