Abstract
Objective: This trial was designed and started recruiting at a time when the benefits of remote ischemic preconditioning during open-heart surgery were still controversial. We focused on a homogeneous patient’s population undergoing either isolated aortic valve replacement (AVR) or coronary artery bypass graft surgery (CABG) by investigating cardiac injury, metabolic stress and inflammatory response.
Methods: A two-centre randomised controlled trial recruited a total of 124 patients between February 2013 and April 2015. Of these 64 patients underwent CABG and 60 patients AVR. Patients were randomized to either sham or preconditioning. Remote ischemic preconditioning was applied following anesthesia and before sternotomy. Myocardial injury and inflammatory response were assessed by serially measuring cardiac troponin I, and IL-6, 8, 10 and TNF-α. Biopsies from left and right ventricles were harvested after ischemic reperfusion injury for nucleotides analysis.
Results: Application of remote ischemic preconditioning did not alter troponin I release, levels of inflammatory markers and cardiac energetics in both CABG or AVR groups.
Conclusions: Preconditioning did not confer any additional cardioprotection in terms of troponin I, inflammatory markers reduction, and left and right ventricle energy metabolites preservation in patients undergoing isolated coronary artery bypass grafting or aortic valve surgery.
Methods: A two-centre randomised controlled trial recruited a total of 124 patients between February 2013 and April 2015. Of these 64 patients underwent CABG and 60 patients AVR. Patients were randomized to either sham or preconditioning. Remote ischemic preconditioning was applied following anesthesia and before sternotomy. Myocardial injury and inflammatory response were assessed by serially measuring cardiac troponin I, and IL-6, 8, 10 and TNF-α. Biopsies from left and right ventricles were harvested after ischemic reperfusion injury for nucleotides analysis.
Results: Application of remote ischemic preconditioning did not alter troponin I release, levels of inflammatory markers and cardiac energetics in both CABG or AVR groups.
Conclusions: Preconditioning did not confer any additional cardioprotection in terms of troponin I, inflammatory markers reduction, and left and right ventricle energy metabolites preservation in patients undergoing isolated coronary artery bypass grafting or aortic valve surgery.
| Original language | English |
|---|---|
| Article number | ezy404 |
| Pages (from-to) | 905-912 |
| Number of pages | 8 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 55 |
| Issue number | 5 |
| Early online date | 12 Dec 2018 |
| DOIs | |
| Publication status | Published - 1 May 2019 |
Research Groups and Themes
- Bristol Heart Institute
- BTC (Bristol Trials Centre)
Keywords
- Remote ischaemic preconditioning
- Coronary artery bypass grafting
- Aortic valve replacement
- Cardiac Injury