Effect of remote ischemic conditioning on myocardial perfusion in patients with suspected ischemic coronary artery disease.
Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperfusion injury and may modulate coronary blood flow. We investigated whether RIC affects resting myocardial perfusion (MP) in patients with suspected ischemic coronary artery disease by quantitative MP imaging.



We included 49 patients with suspected ischemic coronary artery disease. Resting MP was quantified by82Rubidium positron emission tomography/computed tomography (82Rb-PET/CT) imaging before and after RIC, performed as four cycles of 5 minutes upper arm ischemia and reperfusion. Subsequent adenosine82Rb-PET/CT stress-imaging identified non-ischemic and reversibly ischemic myocardial segments. MicroRNA-144 plasma levels were measured before and after RIC. Normalized for rate pressure product, RIC did not affect MP globally (P = .64) or in non-ischemic myocardial segments (P = .58) but decreased MP in reversibly ischemic myocardial segments (-0.11 mL/min/g decrease in MP following RIC; 95% CI -0.17 to -0.06, P < .001). However, we found no effect of RIC when MP was normalized for cardiac work. MicroRNA-144 plasma levels increased following RIC (P = .006) but did not correlate with a change in global MP in response to RIC (P = .40).



RIC did not substantially affect resting MP globally or in non-ischemic and reversibly ischemic myocardial territories in patients with suspected ischemic coronary artery disease.
Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. kpryds@clin.au.dk.|Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark. kpryds@clin.au.dk.
Kasper
K
Pryds
Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Roni Ranghøj
RR
Nielsen
Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark.
Camilla Molich
CM
Hoff
Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark.
Lars Poulsen
LP
Tolbod
Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark.
Kirsten
K
Bouchelouche
Division of Cardiology, Labatt Family Heart Center, Hospital for Sick Children, Toronto, ON, Canada.
Jing
J
Li
Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Michael Rahbek
MR
Schmidt
Heart Institute, University of Cincinnati, Cincinnati, OH, USA.
Andrew N
AN
Redington
Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus N, Denmark.
Jørgen
J
Frøkiær
Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Hans Erik
HE
Bøtker
D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D035683:MicroRNAs / Q000097:blood; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging; D000072078:Positron Emission Tomography Computed Tomography; D011446:Prospective Studies; D012414:Rubidium Radioisotopes
C554293:MIRN144 microRNA, human; D035683:MicroRNAs; D012414:Rubidium Radioisotopes; C000615479:Rubidium-82
82Rb-PET/CT; ischemic heart disease; ischemic preconditioning; microRNA-144; myocardial perfusion; positron emission tomography/computed tomography; remote ischemic conditioning