Effect of remote ischemic conditioning on myocardial perfusion in patients with suspected ischemic coronary artery disease
Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperfusion injury and may modulate coronary blood flow. We investigated whether RIC affects resting myocardial perfusion (MP) in patients with suspected ischemic coronary artery disease by quantitative MP imaging.
Methods and Results
We included 49 patients with suspected ischemic coronary artery disease. Resting MP was quantified by 82Rubidium positron emission tomography/computed tomography (82Rb-PET/CT) imaging before and after RIC, performed as four cycles of 5 minutes upper arm ischemia and reperfusion. Subsequent adenosine 82Rb-PET/CT stress-imaging identified non-ischemic and reversibly ischemic myocardial segments. MicroRNA-144 plasma levels were measured before and after RIC. Normalized for rate pressure product, RIC did not affect MP globally (P = .64) or in non-ischemic myocardial segments (P = .58) but decreased MP in reversibly ischemic myocardial segments (−0.11 mL/min/g decrease in MP following RIC; 95% CI −0.17 to −0.06, P < .001). However, we found no effect of RIC when MP was normalized for cardiac work. MicroRNA-144 plasma levels increased following RIC (P = .006) but did not correlate with a change in global MP in response to RIC (P = .40).
RIC did not substantially affect resting MP globally or in non-ischemic and reversibly ischemic myocardial territories in patients with suspected ischemic coronary artery disease.
Keywords82Rb-PET/CT positron emission tomography/computed tomography ischemic heart disease myocardial perfusion remote ischemic conditioning ischemic preconditioning microRNA-144
82Rubidium positron emission tomography/computed tomography
Myocardial flow reserve
Myocardial vascular resistance
Remote ischemic conditioning
Rate pressure product
The authors thank the staff from Department of Nuclear Medicine, Aarhus University Hospital and Casper Carlsen Elkjær and Anja Helveg Larsen for excellent administrative and technical assistance.
MRS and HEB are shareholders in CellAegis Devices Inc. ANR is member of the Scientific Advisory Board of CellAegis Devices Inc. KP, RRN, CMH, KB, JL and JF report no potential conflict of interest.
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