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远程缺血预处理对心绞痛患者动脉僵硬度和心率变异性的影响。

The Impact of Remote Ischemic Preconditioning on Arterial Stiffness and Heart Rate Variability in Patients with Angina Pectoris.

作者信息

Zagidullin Naufal, Scherbakova Elena, Safina Yuliana, Zulkarneev Rustem, Zagidullin Shamil

机构信息

Department of Internal Diseases, Bashkir State Medical University, Ufa, 450000, Russia.

出版信息

J Clin Med. 2016 Jun 23;5(7):60. doi: 10.3390/jcm5070060.

Abstract

Remote ischemic preconditioning (RIPC) is the set of ischemia episodes that protects against subsequent periods of prolonged ischemia through the cascade of adaptive responses; however, the mechanisms of RIPC are not entirely clear. Here, we aimed to study the impact of RIPC in patients with stable angina pectoris and compare it with healthy individuals with respect to arterial stiffness and heart rate variability. In the randomized, sham-controlled, crossover blind design study, a group of 30 coronary heart disease (CHD) patients (63.9 ± 1.6 years) with stable angina pectoris NYHA II-III and a control group of 20 healthy individuals (58.2 ± 2.49) were both randomly allocated for remote RIPC or sham RIPC. Arterial stiffness, pulse wave velocity (Spygmacor, Australia), and heart rate variability (HRV) were recorded before and after the procedure followed by the crossover examination. In the group of healthy individuals, RIPC showed virtually no impact on the cardiovascular parameters, while, in the CHD group, the systolic and central systolic blood pressure, central pulse pressure, and augmentation decreased, and total power of HRV improved. We conclude that ischemic preconditioning reduces not only systolic blood pressure, but also reduces central systolic blood pressure and improves arterial compliance and heart rate modulation reserve, which may be associated with the antianginal effect of preconditioning.

摘要

远程缺血预处理(RIPC)是指通过一系列适应性反应来保护机体免受随后长时间缺血影响的缺血发作过程;然而,RIPC的机制尚不完全清楚。在此,我们旨在研究RIPC对稳定型心绞痛患者的影响,并就动脉僵硬度和心率变异性方面与健康个体进行比较。在这项随机、假手术对照、交叉盲法设计研究中,一组30例纽约心脏协会(NYHA)II-III级稳定型心绞痛的冠心病(CHD)患者(63.9±1.6岁)和一组20例健康个体(58.2±2.49岁)均被随机分配接受远程RIPC或假RIPC。在操作前后记录动脉僵硬度、脉搏波速度(澳大利亚Spygmacor)和心率变异性(HRV),随后进行交叉检查。在健康个体组中,RIPC对心血管参数几乎没有影响,而在CHD组中,收缩压和中心收缩压、中心脉压及增强指数降低,HRV的总功率改善。我们得出结论,缺血预处理不仅降低收缩压,还降低中心收缩压,并改善动脉顺应性和心率调节储备,这可能与预处理的抗心绞痛作用有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5006/4961991/852072e0c16d/jcm-05-00060-g001.jpg

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