Effects of non-invasive remote ischemic conditioning on rehabilitation after myocardial infarction

(1) Background: Extracellular vesicles (EVs) have been recognized as a cellular communication tool with cardioprotective properties; however, it is unknown whether cardioprotection by remote ischemic conditioning (RIC) involves EVs. (2) Methods: We randomized patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) to additionally receive a protocol of RIC or a sham-intervention. Blood was taken before and immediately, 24 h, four days and one month after PCI. Additionally, we investigated EVs from healthy volunteers undergoing RIC. EVs were characterized by a high-sensitive flow cytometer (Beckman Coulter Cytoflex S, Krefeld, Germany). (3) Results: We analyzed 32 patients (16 RIC, 16 control) and five healthy volunteers. We investigated platelet-, endothelial-, leukocyte-, monocyte- and granulocyte-derived EVs and their pro-thrombotic sub-populations expressing superficial phosphatidylserine (PS+). We did not observe a significant effect of RIC on the numbers of circulating EVs, although granulocyte-derived EVs were significantly higher in the RIC group. In line, RIC had not impact on EVs in healthy volunteers. Additionally, we observed changes of PS+/PEV, EEVs and PS+/CD15+ EVs irrespective of RIC with time following STEMI. 4) Conclusion: We provide further insights into the course of different circulating EVs during the acute and sub-acute phases of STEMI. With respect to the investigated EV populations, RIC seems to have no effect, with only minor differences found for granulocyte EVs.

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Remote ischemic conditioning during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-0834-x ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Ren Gong ◽

Yan-Qing Wu

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Meta Analysis ◽

Coronary Intervention ◽

Remote Ischemic Conditioning ◽

St Segment Elevation ◽

Ischemic Conditioning ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Percutaneous Coronary

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Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction

International Journal of Molecular Sciences ◽

10.3390/ijms20133246 ◽

2019 ◽

Vol 20 (13) ◽

pp. 3246 ◽

Cited By ~ 3

Author(s):

Kasper Pryds ◽

Marie Vognstoft Hjortbak ◽

Michael Rahbek Schmidt

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Medication Use ◽

Remote Ischemic Conditioning ◽

St Segment Elevation ◽

Ischemic Conditioning ◽

Segment Elevation Myocardial Infarction ◽

St Segment

Remote ischemic conditioning (RIC) confers cardioprotection in patients with ST-segment elevation myocardial infarction (STEMI). Despite intense research, the translation of RIC into clinical practice remains a challenge. This may, at least partly, be due to confounding factors that may modify the efficacy of RIC. The present review focuses on cardiovascular risk factors, comorbidities, medication use and procedural variables which may modify the efficacy of RIC in patients with STEMI. Findings of such efficacy modifiers are based on subgroup and post-hoc analyses and thus hold risk of type I and II errors. Although findings from studies evaluating influencing factors are often ambiguous, some but not all studies suggest that smoking, non-statin use, infarct location, area-at-risk of infarction, pre-procedural Thrombolysis in Myocardial Infarction (TIMI) flow, ischemia duration and coronary collateral blood flow to the infarct-related artery may influence on the cardioprotective efficacy of RIC. Results from the on-going CONDI2/ERIC-PPCI trial will determine any clinical implications of RIC in the treatment of patients with STEMI and predefined subgroup analyses will give further insight into influencing factors on the efficacy of RIC.

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Remote ischemic conditioning counteracts the intestinal damage of necrotizing enterocolitis by improving intestinal microcirculation

Nature Communications ◽

10.1038/s41467-020-18750-9 ◽

2020 ◽

Vol 11 (1) ◽

Cited By ~ 1

Author(s):

Yuhki Koike ◽

Bo Li ◽

Niloofar Ganji ◽

Haitao Zhu ◽

Hiromu Miyake ◽

...

Keyword(s):

Necrotizing Enterocolitis ◽

Mechanism Of Action ◽

Intestinal Inflammation ◽

Intestinal Damage ◽

Invasive Treatment ◽

Remote Ischemic Conditioning ◽

Ischemic Conditioning ◽

Non Invasive ◽

Intestinal Microcirculation ◽

Promising Tool

Abstract Necrotizing enterocolitis (NEC) is a devastating disease of premature infants with high mortality rate, indicating the need for precision treatment. NEC is characterized by intestinal inflammation and ischemia, as well derangements in intestinal microcirculation. Remote ischemic conditioning (RIC) has emerged as a promising tool in protecting distant organs against ischemia-induced damage. However, the effectiveness of RIC against NEC is unknown. To address this gap, we aimed to determine the efficacy and mechanism of action of RIC in experimental NEC. NEC was induced in mouse pups between postnatal day (P) 5 and 9. RIC was applied through intermittent occlusion of hind limb blood flow. RIC, when administered in the early stages of disease progression, decreases intestinal injury and prolongs survival. The mechanism of action of RIC involves increasing intestinal perfusion through vasodilation mediated by nitric oxide and hydrogen sulfide. RIC is a viable and non-invasive treatment strategy for NEC.

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