Seven-Day Remote Ischemic Preconditioning Improves Local and Systemic Endothelial Function and Microcirculation in Healthy Humans
Seven-Day Remote Ischemic Preconditioning Improves Local and Systemic Endothelial Function and Microcirculation in Healthy Humans
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DOI：
10.1093/ajh/hpu004
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发表时间：
2014-07-01
影响因子：
3.2
通讯作者：
Thijssen, Dick H. J.
中科院分区：
文献类型：
--
作者：
Jones, Helen;Hopkins, Nicola;Thijssen, Dick H. J.
基础缺血预处理（IPC）对缺血区内外的组织具有保护作用。其目的是检查的假设，每天IPC导致改善内皮功能和皮肤微循环不仅在手臂暴露于IPC，但也在对侧arm. METHODSTirteen健康，年轻，血压正常的男性个体（年龄22 +/- 2岁）被分配到7天每天暴露的手臂IPC（4 × 5分钟）。在7天之前和之后进行肱动脉内皮功能（使用流量介导的扩张（FMD））和前臂微循环（在基线和局部加热期间的皮肤血管电导（CVC））的评估，以检查局部（即，介入臂）和远程（即，对照组）IPC的作用。干预后8天（Post+8）重复评估测试，重复IPC后，（P = 0.03），并在干预后+8时保持显著升高（5.0 +/-2.2%、6.1 +/-2.2%和6.6 +/- 2.3%）和对侧臂（5.4 +/-2.2%、6.0 +/-2.2%和7.5 +/- 2.2%）。前臂CVC在重复IPC后也增加（P = 0.006），并且在两组中在术后+8时保持升高（干预：0.12 +/- 0.03、0.14 +/- 0.04、0.16 +/- 0.04 mV/mm Hg;对侧：0.14 +/- 0.04、0.015 +/- 0.04、0.17 +/- 0.07）。对于FMD和CVC，IPC组与时间之间没有明显的相互作用（均P > 0.05）。IPC干预不改变CVC对局部加热的反应（P > 0.05）。结论每天暴露于IPC 7天导致局部和远端肱动脉FMD和静息皮肤微循环的改善，这些改善在干预停止后仍然存在，并且超过了保护的晚期阶段。这些发现可能与微血管和大血管改善具有临床相关性。
BACKGROUNDIschemic preconditioning (IPC) protects tissue against ischemia-induced injury inside and outside ischemic areas. The purpose was to examine the hypothesis that daily IPC leads to improvement in endothelial function and skin microcirculation not only in the arm exposed to IPC but also in the contralateral arm.METHODSThirteen healthy, young, normotensive male individuals (aged 22 +/- 2 years) were assigned to 7-day daily exposure of the arm to IPC (4 x 5 minutes). Assessment of brachial artery endothelial function (using flow-mediated dilation (FMD)) and forearm microcirculation (cutaneous vascular conductance (CVC) at baseline and during local heating) was performed before and after 7 days to examine the local (i.e., intervention arm) and remote (i.e., control arm) effect of IPC. We repeated the assessment tests 8 days after the intervention (Post+8).RESULTSFMD increased after repeated IPC (P = 0.03) and remained significantly elevated at Post+8 in the intervention (5.0 +/- 2.2%, 6.1 +/- 2.2%, and 6.6 +/- 2.3%) and contralateral arms (5.4 +/- 2.2%, 6.0 +/- 2.2%, and 7.5 +/- 2.2%). Forearm CVC also increased following repeated IPC (P = 0.006) and remained elevated at Post+8 in both arms (intervention: 0.12 +/- 0.03, 0.14 +/- 0.04, 0.16 +/- 0.04 mV/mm Hg; contralateral: 0.14 +/- 0.04, 0.015 +/- 0.04, 0.17 +/- 0.07). No interaction between IPC arm and time was evident for FMD and CVC (both P > 0.05). IPC intervention did not alter CVC responses to local heating (P > 0.05).CONCLUSIONSDaily exposure to IPC for 7 days leads to local and remote improvements in brachial artery FMD and resting skin microcirculation that remain after cessation of the intervention and beyond the late phase of protection. These findings may have clinical relevance for micro-and macrovascular improvements.