Chen Long, Zhou Qianxing, Jin Hong, Zhu Kongbo, Zhi Hong, Chen Zhongpu, Ma Genshan
Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Heart Lung Circ. 2018 Apr;27(4):477-483. doi: 10.1016/j.hlc.2017.03.164. Epub 2017 May 3.
Cardioprotective effects of remote ischaemic conditioning (RIC) in the setting of ischaemic heart disease have been shown recently. But the effects of RIC on heart rate variability (HRV) and cardiac function in patients with stable ischaemic heart failure (IHF) are still unknown.
Fifty patients with stable IHF were enrolled and randomly divided into RIC group and control group. Remote ischaemic conditioning treatment was performed twice a day for 6 weeks. A remote is chaemic conditioning protocol consisted of 4×5min inflation/deflation of the blood pressure cuff applied in the upper arm to create intermittent arm ischaemia. B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), 24-hour ambulatory electrocardiogram, and 6-minute walk distance (6MWD) were all assessed in two groups.
Forty-seven patients completed the study. Remote ischaemic conditioning was well-tolerated by patients in the RIC group after 6 weeks treatment and LVEF showed a significant increase, from 39.2% to 43.4% (p<0.001), as well as decreased BNP, increased 6MWD and HRV, but this was not observed in the control group. In addition, the patients treated with RIC also showed improved NYHA class, LVEF, 6MWD, BNP level and HRV compared to control group.
This study suggests that a 6-week course of RIC treatment could improve cardiac function and HRV in patients with mild and stable IHF, supporting widespread use of RIC in the daily lives of these patients.
近期研究表明，远程缺血预处理（RIC）对缺血性心脏病具有心脏保护作用。但RIC对稳定型缺血性心力衰竭（IHF）患者心率变异性（HRV）及心功能的影响尚不清楚。
纳入50例稳定型IHF患者，随机分为RIC组和对照组。远程缺血预处理治疗每天进行2次，共6周。远程缺血预处理方案包括在上臂使用血压袖带进行4×5分钟的充气/放气，以造成间歇性手臂缺血。两组均评估B型利钠肽（BNP）、左心室射血分数（LVEF）、24小时动态心电图及6分钟步行距离（6MWD）。
47例患者完成研究。RIC组患者在6周治疗后对远程缺血预处理耐受性良好，LVEF显著升高，从39.2%升至43.4%（p<0.001），BNP降低，6MWD及HRV升高，而对照组未观察到这些变化。此外，与对照组相比，接受RIC治疗的患者NYHA分级、LVEF、6MWD、BNP水平及HRV也有所改善。
本研究表明，为期6周的RIC治疗疗程可改善轻度稳定型IHF患者的心功能及HRV，支持在这些患者的日常生活中广泛应用RIC。
