| Objective: To study the effect of remote ischemic post-conditioning on PCI associated myocardial injury in patients with coronary heart disease.Methods: A total of 48 Patients with coronary heart disease were enrolled,They were randomly divided into 2 groups: control group(n=22,an uninflated cuff around the arm)and remote ischemic postconditioning group(n=26,induced by three 5-minute inflations of a blood pressure cuff to 200 mm Hg around the left upper arm,followed by 5-minute intervals of reperfusion before 1 to 4 hours before PCI).Clinical conditions after PCI and major adverse cardiac and cerebral event rate at 6 months were compared between the two groups.We compared the myocardial markers of high-sensitivity troponin T(hs-c Tn T)level before PCI and 6h,12 h,24h after PCI;cardiac functions were detected by echocardiography before and 6 month after PCI;serum interleukin-6(IL-6)and high mobility group protein B1(HMGB1),soluble advanced glycation end product receptor(s RAGE)were detected by enzyme-linked immunosorbent assay(ELISA)method in different time points after PCI.Results: 12 hours after PCI,the average level of hsc Tn T in RIPost C group was significantly decreased compared with control group(62.33 ± 24.35 vs 96.48 ± 36.88ng/ml,P<0.01).The proportion of patients with hsc Tn T>300ng/ml in control group was increased significantly(41.67% vs 11.76%,P=0.0037)compared withRIPost C group.The ischemic changes in ECG and the patient with angina were lower in RIPost C group compared with the control group.MACCE after 6 months had no statistical significant difference in two group(11.54% vs 22.72% P>0.05).There were no significant differences of IL-6,HMGB1 and s RAGE before PCI and 6h,24 h after PCI between two groups(P>0.05).The levels of IL-6,HMGB1 and s RAGE were significantly lower in RIPost C group compared with the control group 12 hour after PCI(12h-IL-6:1.95 ± 0.81ng/ml vs 2.57 ± 1.42 ng/ml,P=0.026;12h-HMGB1:8.14 ± 3.50 ng/ml vs 10.72 ± 5.39 ng/ml,P=0.037).The levels of s RAGE 12 h after PCI was significantly higher in the RIPost C group compared with the control group.The serum levels of IL-6 and RAGE of coronary sinus were significantly lower in the RIPost C group than the control group.The serum levels of s RAGE of coronary sinus was significantly higher in the RIPost C group than the control group.Conclusion: Remote ischemic postconditioning can effectively reduce myocardial injury and systemic inflammatory response in patients with coronary heart disease after PCI.Objective: To study the effect of remote ischemic post-conditioning on Myocardial Ischmia Reperfusion injury in mice.Methods: Mice model of MIRI was established by occlusion of the LAD for 45 min and then loosening for 120 min.Then the mice were randomly divided into three groups: control group(sham),ischemia reperfusion group(IR group)and remote ischemic preconditioning group(RIPost C group).Infarction size was detected by Evans blue and TTC staining 2 hour after reperfusion.Cardiac function was detected by echocardiography measurement 24 hour after reperfusion.We also observe the movement and sensation of ischemic lower limb in the RIPost C group.Results: The infarct size was lower in the RIPost C group compared with I/R group(40.72%±2.49 vs 29.75%±1.97,P?0.01).RIPost C could increase LVEF and FS compared with I/R group(EF%: 37.25±2.06 vs 31.25±2.27;FS%: 21.22±2.34 vs 16.16±2.28,P?0.05).Left lower limb paralysis occurred in one mice in the RIpost C group,and left lower limb muscle strength decreased after ischemia and reperfusion occurred in two mice.Conclusion: Remote ischemic post-conditioning can decrease infarct size and improve cardiac function after ischemic reperfusion injury in mice.It represents a potential therapeutic approach for treatment of ischemic reperfusion injury.Objective: To study the effect of RAGE-HMGB1,PI3K/Akt and ERKl/2 signal pathway on remote ischemic post-conditioning in mice with myocardial ischmia Reperfusion injury.Methods: Mice model of MIRI was established by occlusion of the LAD for 45 min and then loosening for 120 min.Then the mice were randomly divided into three groups: control group(sham),ischemia reperfusion group(IR group)and remote ischemic preconditioning group(RIPost C group).RAGE、HMGB1、P-AKT、ERK1/2 were detected by Western Blot 2 hour after reperfusion.Results: 2 hours after myocardial ischmia reperfusion injury,the level of RAGE and HMGB1 were significantly decreased compared with I/R group(RAGE: 0.29 ± 0.21 vs 0.40 ± 0.29,HMGB-1: 0.30 ± 0.10 vs 0.61 ± 0.93,P<0.05).The level of p-AKT was significantly higher in the RIPost C group than the I/R group(0.69 ± 0.24 vs 0.49 ± 0.27,P<0.05).There was no significantly different in the level of ERK1/2.Conclusion: Remote ischemic post-conditioning can inhibit the expression of rage and HMGB1,activate PI3 K / Akt signaling pathway.It could further suppress the oxidative stress,anti apoptosis and reduce inflammatory reaction,but this effect has a certain timeliness. |
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