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01.12.2021 | Original Contribution

Vascular conditioning prevents adverse left ventricular remodelling after acute myocardial infarction: a randomised remote conditioning study

verfasst von: Ignatios Ikonomidis, Dimitrios Vlastos, Ioanna Andreadou, Maria Gazouli, Panagiotis Efentakis, Maria Varoudi, George Makavos, Alkistis Kapelouzou, John Lekakis, John Parissis, Spiridon Katsanos, Damianos Tsilivarakis, Derek J. Hausenloy, Dimitrios Alexopoulos, Dennis V. Cokkinos, Hans-Eric Bøtker, Efstathios K. Iliodromitis

Erschienen in: Basic Research in Cardiology | Ausgabe 1/2021

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Abstract

Aims

Remote ischemic conditioning (RIC) alleviates ischemia–reperfusion injury via several pathways, including micro-RNAs (miRs) expression and oxidative stress modulation. We investigated the effects of RIC on endothelial glycocalyx, arterial stiffness, LV remodelling, and the underlying mediators within the vasculature as a target for protection.

Methods and results

We block-randomised 270 patients within 48 h of STEMI post-PCI to either one or two cycles of bilateral brachial cuff inflation, and a control group without RIC. We measured: (a) the perfusion boundary region (PBR) of the sublingual arterial microvessels to assess glycocalyx integrity; (b) the carotid-femoral pulse wave velocity (PWV); (c) miR-144,-150,-21,-208, nitrate-nitrite (NOx) and malondialdehyde (MDA) plasma levels at baseline (T0) and 40 min after RIC onset (T3); and (d) LV volumes at baseline and after one year. Compared to baseline, there was a greater PBR and PWV decrease, miR-144 and NOx levels increase (p < 0.05) at T3 following single- than double-cycle inflation (PBR:ΔT0–T3 = 0.249 ± 0.033 vs 0.126 ± 0.034 μm, p = 0.03 and PWV:0.4 ± 0.21 vs −1.02 ± 0.24 m/s, p = 0.03). Increased miR-150,-21,-208 (p < 0.05) and reduced MDA was observed after both protocols. Increased miR-144 was related to PWV reduction (r = 0.763, p < 0.001) after the first-cycle inflation in both protocols. After one year, single-cycle RIC was associated with LV end-systolic volume reduction (LVESV) > 15% (odds-ratio of 3.75, p = 0.029). MiR-144 and PWV changes post-RIC were interrelated and associated with LVESV reduction at follow-up (r = 0.40 and 0.37, p < 0.05), in the single-cycle RIC.

Conclusion

RIC evokes “vascular conditioning” likely by upregulation of cardio-protective microRNAs, NOx production, and oxidative stress reduction, facilitating reverse LV remodelling.

Clinical Trial Registration

http://www.clinicaltrials.gov. Unique identifier: NCT03984123.

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Titel: Vascular conditioning prevents adverse left ventricular remodelling after acute myocardial infarction: a randomised remote conditioning study
verfasst von: Ignatios Ikonomidis
Dimitrios Vlastos
Ioanna Andreadou
Maria Gazouli
Panagiotis Efentakis
Maria Varoudi
George Makavos
Alkistis Kapelouzou
John Lekakis
John Parissis
Spiridon Katsanos
Damianos Tsilivarakis
Derek J. Hausenloy
Dimitrios Alexopoulos
Dennis V. Cokkinos
Hans-Eric Bøtker
Efstathios K. Iliodromitis
Publikationsdatum: 01.12.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Basic Research in Cardiology / Ausgabe 1/2021
Print ISSN: 0300-8428
Elektronische ISSN: 1435-1803
DOI: https://doi.org/10.1007/s00395-021-00851-1

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Vascular conditioning prevents adverse left ventricular remodelling after acute myocardial infarction: a randomised remote conditioning study

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