Schöneburg Charlotte, Seyram Amevor Benedicta, Bauer Theresa, Boateng Ivy, Nsia-Tawia Bright, Öztürk Nehir, Pop Maria-Alexandra, Müller Jan
Institute of Preventive Pediatrics, Technical University Munich, 80992 Munich, Germany.
J Cardiovasc Dev Dis. 2024 Jun 26;11(7):193. doi: 10.3390/jcdd11070193.
(1) Background: Remote ischemic preconditioning (RIPC) is an intervention involving the application of brief episodes of ischemia and reperfusion to distant tissues to activate protective pathways in the heart. There is evidence suggesting the involvement of the autonomic nervous system (ANS) in RIPC-induced cardioprotection. This study aimed to investigate the immediate effects of RIPC on the ANS using a randomized controlled trial. (2) Methods: From March 2018 to November 2018, we conducted a single-blinded randomized controlled study involving 51 healthy volunteers (29 female, 24.9 [23.8, 26.4] years). Participants were placed in a supine position and heart rate variability was measured over 260 consecutive beats before they were randomized into either the intervention or the SHAM group. The intervention group underwent an RIPC protocol (3 cycles of 5 min of 200 mmHg ischemia followed by 5 min reperfusion) at the upper thigh. The SHAM group followed the same protocol but on the right upper arm, with just 40 mmHg of pressure inflation, resulting in no ischemic stimulus. Heart rate variability measures were reassessed afterward. (3) Results: The intervention group showed a significant increase in RMSSD, the possible marker of the parasympathetic nervous system (IG: 14.5 [5.4, 27.5] ms vs. CG: 7.0 [-4.3, 23.1 ms], p = 0.027), as well as a significant improvement in Alpha 1 levels compared to the control group (IG: -0.1 [-0.2, 0.1] vs. CG: 0.0 [-0.1, 0.2], p = 0.001). (4) Conclusions: Our results hint that RIPC increases the RMSSD and Alpha 1 parameters showing possible immediate parasympathetic modulations. RIPC could be favorable in promoting cardioprotective or/and cardiovascular effects by ameliorating ANS modulations.
（1）背景：远程缺血预处理（RIPC）是一种干预措施，通过对远处组织施加短暂的缺血和再灌注，以激活心脏中的保护通路。有证据表明自主神经系统（ANS）参与了RIPC诱导的心脏保护作用。本研究旨在通过随机对照试验研究RIPC对自主神经系统的即时影响。（2）方法：2018年3月至2018年11月，我们进行了一项单盲随机对照研究，纳入51名健康志愿者（29名女性，年龄24.9[23.8，26.4]岁）。参与者仰卧位，在随机分为干预组或假手术组之前，连续测量260次心跳的心率变异性。干预组在上大腿进行RIPC方案（3个周期，每个周期200 mmHg缺血5分钟，然后再灌注5分钟）。假手术组遵循相同方案，但在右上臂，仅施加40 mmHg的压力充气，不产生缺血刺激。之后重新评估心率变异性指标。（3）结果：干预组中，代表副交感神经系统的RMSSD显著增加（干预组：14.5[5.4，27.5]ms，对照组：7.0[-4.3，23.1]ms，p = 0.027），与对照组相比，α1水平也有显著改善（干预组：-0.1[-0.2，0.1]，对照组：0.0[-0.1，0.2]，p = 0.001）。（4）结论：我们的结果提示，RIPC增加了RMSSD和α1参数，表明可能存在即时的副交感神经调节作用。RIPC可能通过改善自主神经系统调节，对促进心脏保护和/或心血管效应有益。
