title: Remote ischaemic postconditioning protects the heart during acute myocardial infarction in pigs.
abstract: BACKGROUND
  Ischaemic preconditioning results in a reduction in ischaemic-reperfusion injury to the heart. This beneficial effect is seen both with direct local preconditioning of the myocardium and with remote preconditioning of easily accessible distant non-vital limb tissue. Ischaemic postconditioning with a comparable sequence of brief periods of local ischaemia, when applied immediately after the ischaemic insult, confers benefits similar to preconditioning.
  
  
  OBJECTIVE
  To test the hypothesis that limb ischaemia induces remote postconditioning and hence reduces experimental myocardial infarct size in a validated swine model of acute myocardial infarction.
  
  
  METHODS
  Acute myocardial infarction was induced in 24 pigs with 90 min balloon inflations of the left anterior descending coronary artery. Remote ischaemic postconditioning was induced in 12 of the pigs by four 5 min cycles of blood pressure cuff inflation applied to the lower limb immediately after the balloon deflation. Infarct size was assessed by measuring 72 h creatinine kinase release, MRI scan and immunohistochemical analysis.
  
  
  RESULTS
  Area under the curve of creatinine kinase release was significantly reduced in the postconditioning group compared with the control group with a 26% reduction in the infarct size (p<0.05). This was confirmed by MRI scanning and immunohistochemical analysis that revealed a 22% (p<0.05) and a 47.52% (p<0.01) relative reduction in the infarct size, respectively.
  
  
  CONCLUSIONS
  Remote ischaemic postconditioning is a simple technique to reduce infarct size without the hazards and logistics of multiple coronary artery balloon inflations. This type of conditioning promises clear clinical potential.
authors: Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary.
authors: Gyorgy
authors: G
authors: Andreka
authors: Marton
authors: M
authors: Vertesaljai
authors: Gergely
authors: G
authors: Szantho
authors: Gusztav
authors: G
authors: Font
authors: Zsolt
authors: Z
authors: Piroth
authors: Geza
authors: G
authors: Fontos
authors: Eszter D
authors: ED
authors: Juhasz
authors: Laszlo
authors: L
authors: Szekely
authors: Zsolt
authors: Z
authors: Szelid
authors: Mark S
authors: MS
authors: Turner
authors: Houman
authors: H
authors: Ashrafian
authors: Michael P
authors: MP
authors: Frenneaux
authors: Peter
authors: P
authors: Andreka
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D019540:Area Under Curve; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D009203:Myocardial Infarction / Q000201:enzymology / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology*; D034421:Sus scrofa
chemical_list: D003402:Creatine Kinase