Z Cao1, R Shen1, X Zhang1, G Cheng1, Z Yan2. 1. Department of Cardiac Surgery, Affiliated Province Hospital of Anhui Medical University, Hefei, 230001, China. 2. Department of Cardiac Surgery, Affiliated Province Hospital of Anhui Medical University, Hefei, 230001, China. anhuixzwk@163.com.
Abstract
BACKGROUND: This study investigated the effects of remote ischemic preconditioning (RIPC) on acute myocardial injury and clinical outcome in adult patients undergoing valve replacement surgery. METHODS:Sixty-three adult patients scheduled for elective valve replacement undergoing cardiopulmonary bypass (CPB) were randomly assigned to control or remote ischemic preconditioning treatment. RIPC was applied beginning with the first surgical incision by three times of inflating the cuff to 200 mmHg for 5 min, followed by 5 min of deflation. The plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) were determined. The preoperative, intraoperative, and postoperative characteristics, and hemodynamics values were recorded during the study. RESULTS: There were no significant differences in patient preoperative, intraoperative, and postoperative characteristics and hemodynamics values between groups. The activity of CK-MB and cTnI was significantly lower in RIPC group than CON group at 4 and 48 h after aortic unclamping. CONCLUSIONS: The present study demonstrated that remote ischemic preconditioning might reduce release of CK-MB and cTnI in patients undergoing valve replacement. However, RIPC does not improve the clinical outcome of these patients.
RCT Entities:
BACKGROUND: This study investigated the effects of remote ischemic preconditioning (RIPC) on acute myocardial injury and clinical outcome in adult patients undergoing valve replacement surgery. METHODS: Sixty-three adult patients scheduled for elective valve replacement undergoing cardiopulmonary bypass (CPB) were randomly assigned to control or remote ischemic preconditioning treatment. RIPC was applied beginning with the first surgical incision by three times of inflating the cuff to 200 mmHg for 5 min, followed by 5 min of deflation. The plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) were determined. The preoperative, intraoperative, and postoperative characteristics, and hemodynamics values were recorded during the study. RESULTS: There were no significant differences in patient preoperative, intraoperative, and postoperative characteristics and hemodynamics values between groups. The activity of CK-MB and cTnI was significantly lower in RIPC group than CON group at 4 and 48 h after aortic unclamping. CONCLUSIONS: The present study demonstrated that remote ischemic preconditioning might reduce release of CK-MB and cTnI in patients undergoing valve replacement. However, RIPC does not improve the clinical outcome of these patients.
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