Remote Ischaemic Preconditioning for Heart Surgery (RIPHeart-Study)

心脏手术的远程缺血预处理（RIPHeart 研究）

• 批准号: 129494800
• 负责人: Professor Dr. Patrick Meybohm
• 金额: --
• 依托单位: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie
• 依托单位国家: 德国
• 项目类别: Clinical Trials
• 财政年份: 2010
• 资助国家: 德国
• 起止时间: 2009-12-31 至 2013-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/129494800?language=en
• 关键词: Remote; Ischaemic; Preconditioning; Heart; Surgery

Cardiac surgery is associated with a predictable incidence of myocardial, neurological and renal dysfunction that account for significant perioperative morbidity and mortality. Transient ischaemia of nonvital tissue has been shown to enhance the tolerance of remote organs to cope with a subsequent prolonged ischaemic event in a number of clinical situations, a phenomenon known as remote ischaemic preconditioning. We hypothesise that remote ischaemic preconditioning improves patient’s outcome after surgery compared to no active intervention. We conduct a prospective, randomised, double-blind, multicentre, controlled trial including 2070 patients undergoing cardiac surgery in which cardiopulmonary bypass is used. Patients will be randomized either to the remote ischaemic preconditioning group receiving four cycles of transient upper limb ischaemia/reperfusion using a blood-pressure cuff inflated to a pressure 15 mm Hg higher than the systolic arterial pressure after induction of anaesthesia, or to the control group receiving four cycles of transient upper limb ‘pseudo’-inflation/deflation to a pressure of 20 mm Hg. Primary endpoint is a composite outcome (all-cause mortality, non-fatal myocardial infarction, any new stroke, and/or acute renal failure) within 30 days after surgery. Secondary endpoints are any component of the composite endpoint within 1 year after surgery, length of hospital stay, myocardial damage, myocardial function (echocardiography), new onset of a trial fibrillation, neurocognitive function test, and acute kidney injury.

心脏手术与可预测的心肌、神经和肾功能障碍的发生率相关，这些功能障碍是围手术期发病率和死亡率的重要原因。在许多临床情况下，非生命组织的短暂缺血已被证明可以增强远端器官的耐受性，以应对随后的长期缺血事件，这种现象称为远端缺血预处理。我们假设，与不进行主动干预相比，远程缺血预处理可以改善患者术后的预后。我们开展了一项前瞻性、随机、双盲、多中心对照试验，纳入了 2070 名接受体外循环心脏手术的患者。患者将被随机分配到远程缺血预适应组，接受四个周期的短暂上肢缺血/再灌注，使用血压袖带在麻醉诱导后充气至比收缩动脉压高 15 毫米汞柱，或对照组接受四个周期的短暂上肢“伪”充气/放气至压力 20 毫米汞柱。主要终点是术后 30 天内的复合结局（全因死亡率、非致命性心肌梗塞、任何新发卒中和/或急性肾衰竭）。次要终点是术后 1 年内复合终点的任何组成部分、住院时间、心肌损伤、心肌功能（超声心动图）、新发试验性颤动、神经认知功能测试和急性肾损伤。

项目成果

Remote ischemic preconditioning regulates HIF-1α levels, apoptosis and inflammation in heart tissue of cardiosurgical patients: a pilot experimental study

• DOI: 10.1007/s00395-012-0314-0
• 发表时间: 2013-01-01
• 期刊: BASIC RESEARCH IN CARDIOLOGY
• 影响因子: 9.5
• 作者: Albrecht, Martin;Zitta, Karina;Meybohm, Patrick
• 通讯作者: Meybohm, Patrick

Activities of cardiac tissue matrix metalloproteinases 2 and 9 are reduced by remote ischemic preconditioning in cardiosurgical patients with cardiopulmonary bypass

体外循环心脏外科患者的远程缺血预处理降低了心脏组织基质金属蛋白酶 2 和 9 的活性

• DOI: 10.1186/1479-5876-12-94
• 发表时间: 2014
• 期刊: Journal of Translational Medicine
• 影响因子: 7.4
• 作者: Zitta K;Meybohm P;Bein B;Grünewald M;Lauer F;Steinfath M;Cremer J;Zacharowski K;Albrecht M
• 通讯作者: Albrecht M