title: Remote ischaemic preconditioning reduces myocardial injury in patients undergoing heart valve surgery: randomised controlled trial.
abstract: OBJECTIVE
  To determine whether remote ischaemic preconditioning (RIPC) is cardioprotective in patients undergoing heart valve replacement.
  
  
  METHODS
  Single-blinded, randomised controlled trial.
  
  
  METHODS
  Tertiary referral hospital in China.
  
  
  METHODS
  Adult patients (31-72 years) undergoing mitral valve, aortic valve or tricuspid valve surgery.
  
  
  METHODS
  Patients were randomised to either the RIPC (n=38) or control (n=35) group. After induction of anaesthesia, patients in the RIPC group underwent three 5 min cycles of right upper limb ischaemia, induced by an automated cuff-inflator placed on the upper arm and inflated to 200 mm Hg. Each cycle was interrupted by a 5 min period of reperfusion during which time the cuff was deflated. The control group had only a deflated cuff placed on the upper arm for 30 min.
  
  
  METHODS
  Serum troponin I concentration was measured before surgery and at 6, 12, 24, 48, and 72 h postoperatively. The cardiac function of all patients was followed postoperatively.
  
  
  RESULTS
  Troponin I concentration was reduced in the RIPC group (398.7±179.3 μg/l) compared with the control group (708.4±242.5 μg/l). Mean difference was 309.7±50.8 (95% CI 210.1 to 409.3, p<0.0001). A greater improvement in postsurgical cardiac function was noted in the RIPC group than in the control group.
  
  
  CONCLUSIONS
  These data indicate that RIPC reduces myocardial injury and improves cardiac function in patients undergoing heart valve surgery.
  
  
  BACKGROUND
  NCT01175681.
authors: Surgery/Cardiothoracic, Guangzhou First Municipal People's Hospital, Guangzhou Institute of Clinical Medicine, Guangzhou Medical College, Guangzhou, PR China.
authors: Jian-Jiang
authors: JJ
authors: Xie
authors: Xiao-Long
authors: XL
authors: Liao
authors: Wen-Guang
authors: WG
authors: Chen
authors: Da-De
authors: DD
authors: Huang
authors: Feng-Jun
authors: FJ
authors: Chang
authors: Wen
authors: W
authors: Chen
authors: Zhao-Liu
authors: ZL
authors: Luo
authors: Zhi-Ping
authors: ZP
authors: Wang
authors: Jing-Song
authors: JS
authors: Ou
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000097:blood / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015994:Incidence; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D011379:Prognosis; D012189:Retrospective Studies; D016037:Single-Blind Method; D017216:Telemedicine / Q000379:methods*; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I