Effects of remote ischemic preconditioning on acute myocardial injury in patients undergoing valve replacement

Abstract

This study investigated the effects of remote ischemic preconditioning (RIPC) on acute myocardial injury and clinical outcome in adult patients undergoing valve replacement surgery. 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 200mmHg for 5min, followed by 5min 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. 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 48h after aortic unclamping. 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.