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Remote ischaemic pre‐conditioning does not attenuate ischaemic left ventricular dysfunction in humans
Author(s) -
Hoole Stephen P.,
Khan Sadia N.,
White Paul A.,
Heck Patrick M.,
Kharbanda Rajesh K.,
Densem Cameron G.,
Clarke Sarah C.,
Shapiro Leonard M.,
Schofield Peter M.,
O'Sullivan Michael,
Dutka David P.
Publication year - 2009
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfp040
Subject(s) - medicine , cardiology , ejection fraction , ventricle , dobutamine , ischemia , myocardial stunning , stunning , ischemic preconditioning , anesthesia , hemodynamics , heart failure
Aims Remote ischaemic pre‐conditioning (RIPC) reduces distant tissue ischaemia reperfusion injury. We tested the hypothesis that RIPC would protect the left ventricle (LV) from ischaemic dysfunction and stunning. Methods and results Forty‐two patients with single vessel coronary disease and normal LV function were prospectively recruited. Twenty patients had repeated conductance catheter assessment of LV function during serial coronary occlusions with/without RIPC and a further 22 patients underwent serial dobutamine stress echocardiography and tissue Doppler analysis with/without RIPC. Remote ischaemic pre‐conditioning was induced by three 5 min inflations of a blood pressure cuff around the upper arm. RIPC did not diminish the degree of ischaemic LV dysfunction during coronary balloon occlusion (Tau, ms: 59.2 (2.8) vs. 62.8 (2.8), P = 0.15) and there was evidence of cumulative LV dysfunction despite RIPC [ejection fraction (EF), %: 54.3 (5.8) vs. 44.9 (3.7), P = 0.03]. Remote ischaemic pre‐conditioning did not improve contractile recovery during reperfusion (EF, %: 51.7 (3.6) vs. 51.5 (5.7), P = 0.88 and Tau, ms: 55.6 (2.8) vs. 56.0 (2.0), P = 0.85). A neutral effect of RIPC on LV function was confirmed by tissue Doppler analysis of ischaemic segments at peak dobutamine ( V s , cm s −1 control: 8.2 (0.4) vs. RIPC 8.1 (0.4), P = 0.43) and in recovery. Conclusion RIPC does not attenuate ischaemic LV dysfunction in humans.