Objective To investigate whether there is a protecting effect of remote ischemic preconditioning (RIPC) on patients underwent cardiac valvular surgery. Method We retrospectively analyzed the clinical data of 72 adult patients underwent cardiac valvular surgery in our hospital from Febuary 2014 through April 2015 year. There were 26 males and 46 females with an age ranging from 23-68 years. We devided 72 patients into a RIPC group and a control group. There were 14 males and 28 females with a mean age of 48.87±12.28 years in the RIPC group. After the induction of anesthesia, the RIPC group was induced by three cycles of right upper limb ischemia and reperfusion using a blood pressure cuff. The blood pressure cuff was inflated to 200 mm Hg and we held it on for 5 minutes, deflated to 0 mm Hg and maintained for 5 minutes, which was defined as one cycle. There were 10 males and 20 females with a mean age of 47.70±8.07 years in the control group. We placed a standard blood pressure gasbag on the right upper limb for 30 minutes without inflation in the control group. We recorded the clinical data including cardiopulmonary bypass (CPB) time, the cross-clamping time of ascending aorta, preoperative ejection fraction (EF), EF after discharging, postoperative complica-tion and mortality. Blood were sampled preoperatively (T₀), 30 minutes after RIPC (T₁), 30 minutes aftr the cardiopul-monary bypass finished (T₂), 24 hours (T₃), 48 hours (T₄) and 72 hours (T₅) after surgery to detect the concentration of troponin T (cTnT) and creatine kinase-MB (CK-MB). We counted the person-time used dopamine and norepinephrine. Result There was no death in both groups. The mechanical ventilation time, the time of ICU stay, the time of hospital stay, the number of person used vasoactive agent, and the EF when discharging showed no statistical difference between the two groups. Levels of cTNT in the RIPC group were statistically lower than those in the control group at T₂ and T₃ (P=0.001, P=0.001). Levels of CK-MB in the RIPC group were statistically lower than those in the control group at T₂, T₃, and T₄ (P=0.011, P=0.010, P=0.033). Conclusion RIPC may have protective effect on myocardium for patients underwent cardiac valvular surgery.

Citation： LUOXuan, XUEYun-xing, TIANCong-cong, WANGDong-jin. Protecting Effect of Remote Ischemic Preconditioning on Myocardium in Cardiac Valve Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 769-772. doi: 10.7507/1007-4848.20160185 Copy