title: Release of a humoral circulating cardioprotective factor by remote ischemic preconditioning is dependent on preserved neural pathways in diabetic patients.
abstract: Efficacy of ischemic preconditioning is decreased in animal models of type 2 diabetes mellitus while the responses in humans with diabetes are contradictory. It is unknown whether attenuation is related to decreased release of a mediating humoral cardioprotective factor or reduced ability to respond in the target tissue. The aim of the present study was to investigate the release and effect of a circulating cardioprotective factor in type 2 diabetes mellitus patients. Blood samples were drawn from nine non-diabetic subjects, eight diabetic patients without peripheral neuropathy, and eight diabetic patients with peripheral neuropathy before (control) and after a remote ischemic preconditioning (rIPC) stimulus. Blood samples were dialyzed against Krebs-Henseleit buffer and the cardioprotective effects of the dialysates were tested in rabbit hearts mounted on a Langendorff model and subjected to 30-min global ischemia and 120-min reperfusion. rIPC dialysate from non-diabetic and diabetic subjects without peripheral neuropathy reduced infarct size and improved hemodynamic recovery compared to control dialysate from non-diabetic and diabetic subjects. However, in the subgroup of diabetic patients with neuropathy the cardioprotective effect was attenuated. These findings indicate that the release mechanism involves neural pathways.
authors: Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, Aarhus N, Denmark. rebekka.vibjerg@ki.au.dk
authors: Rebekka Vibjerg
authors: RV
authors: Jensen
authors: Nicolaj Brejnholt
authors: NB
authors: Støttrup
authors: Steen Buus
authors: SB
authors: Kristiansen
authors: Hans Erik
authors: HE
authors: Bøtker
mesh_terms: D000368:Aged; D000818:Animals; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D019289:Pyruvic Acid / Q000378:metabolism; D011817:Rabbits
chemical_list: D019344:Lactic Acid; D019289:Pyruvic Acid