Long-term, regular remote ischemic preconditioning improves endothelial function in patients with coronary heart disease.
Remote ischemic preconditioning (RIPre) can prevent myocardial injury. The purpose of this study was to assess the beneficial effects of long-term regular RIPre on human arteries. Forty patients scheduled for coronary artery bypass graft (CABG) surgery were assigned randomly to a RIPre group (n=20) or coronary heart disease (CHD) group (n=20). Twenty patients scheduled for mastectomy were enrolled as a control group. RIPre was achieved by occluding arterial blood flow 5 min with a mercury sphygmomanometer followed by a 5-min reperfusion period, and this was repeated 4 times. The RIPre procedure was repeated 3 times a day for 20 days. In all patients, arterial fragments discarded during surgery were collected to evaluate endothelial function by flow-mediated dilation (FMD), CD34(+) monocyte count, and endothelial nitric oxide synthase (eNOS expression). Phosphorylation levels of STAT-3 and Akt were also assayed to explore the underlying mechanisms. Compared with the CHD group, long-term regular RIPre significantly improved FMD after 20 days (8.5±2.4 vs 4.9±4.2%, P<0.05) and significantly reduced troponin after CABG surgery (0.72±0.31 and 1.64±0.19, P<0.05). RIPre activated STAT-3 and increased CD34(+) endothelial progenitor cell counts found in arteries. Long-term, regular RIPre improved endothelial function in patients with CHD, possibly due to STAT-3 activation, and this may have led to an increase in endothelial progenitor cells.
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Y
Y
Liang
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Y P
YP
Li
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
F
F
He
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
X Q
XQ
Liu
Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Y
JY
Zhang
D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D015153:Blotting, Western; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000503:physiopathology* / Q000517:prevention & control* / Q000601:surgery; D066026:Endothelial Progenitor Cells; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000517:prevention & control; D052250:Nitric Oxide Synthase Type III / Q000032:analysis; D060888:Real-Time Polymerase Chain Reaction; D050796:STAT3 Transcription Factor / Q000032:analysis; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
D018952:Antigens, CD34; D050796:STAT3 Transcription Factor; D052250:Nitric Oxide Synthase Type III