Remote ischemic preconditioning prevents reduction in brachial artery flow-mediated dilation after strenuous exercise

Tom G. Bailey, Gurpreet K. Birk, N. Timothy Cable, Greg Atkinson, Daniel J. Green, Helen Jones, Dick H.J. Thijssen

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Abstract

Strenuous exercise is associated with an immediate decrease in endothelial function. Repeated bouts of ischemia followed by reperfusion, known as remote ischemic preconditioning (RIPC), is able to protect the endothelium against ischemia-induced injury beyond the ischemic area. We examined the hypothesis that RIPC prevents the decrease in endothelial function observed after strenuous exercise in healthy men. In a randomized, crossover study, 13 healthy men performed running exercise preceded by RIPC of the lower limbs (4 × 5-min 220-mmHg bilateral occlusion) or a sham intervention (sham; 4 × 5-min 20-mmHg bilateral occlusion). Participants performed a graded maximal treadmill running test, followed by a 5-km time trial (TT). Brachial artery endothelial function was examined before and after RIPC or sham, as well as after the 5-km TT. We measured flowmediated dilation (FMD), an index of endothelium-dependent function, using high-resolution echo-Doppler. We also calculated the shear rate area-under-the-curve (from cuff deflation to peak dilatation; SRAUC). Data are described as mean and 95% confidence intervals. FMD changed by < 0.6% immediately after both ischemic preconditioning (IPC) and sham interventions (P>0.30). In the sham trial, FMD changed from 5.1 (4.4 -5.9) to 3.7% (2.6-4.8) following the 5-km TT (P =0.02). In the RIPC trial, FMD changed negligibly from 5.4 (4.4-6.4) post-IPC and 5.7% (4.6-6.8) post 5-km TT (P =0.60). Baseline diameter, SRAUC, and time-to-peak diameter were all increased following the 5-km TT (P < 0.05), but these changes did not influence the IPC-mediated maintenance of FMD. In conclusion, these data indicate that strenuous lower-limb exercise results in an acute decrease in brachial artery FMD of ~1.4% in healthy men. However, we have shown for the first time that prior RIPC of the lower limbs maintains postexercise brachial artery endothelium-dependent function at preexercise levels.

Original languageEnglish
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume303
Issue number5
DOIs
Publication statusPublished - 1 Sep 2012

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Ischemic Preconditioning
Brachial Artery
Dilatation
Exercise
Endothelium
Lower Extremity
Ischemia
Exercise Test
Running
Cross-Over Studies
Reperfusion
Area Under Curve
Maintenance
Confidence Intervals
Wounds and Injuries

Cite this

Bailey, Tom G. ; Birk, Gurpreet K. ; Timothy Cable, N. ; Atkinson, Greg ; Green, Daniel J. ; Jones, Helen ; Thijssen, Dick H.J. / Remote ischemic preconditioning prevents reduction in brachial artery flow-mediated dilation after strenuous exercise. In: American Journal of Physiology - Heart and Circulatory Physiology. 2012 ; Vol. 303, No. 5.
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abstract = "Strenuous exercise is associated with an immediate decrease in endothelial function. Repeated bouts of ischemia followed by reperfusion, known as remote ischemic preconditioning (RIPC), is able to protect the endothelium against ischemia-induced injury beyond the ischemic area. We examined the hypothesis that RIPC prevents the decrease in endothelial function observed after strenuous exercise in healthy men. In a randomized, crossover study, 13 healthy men performed running exercise preceded by RIPC of the lower limbs (4 × 5-min 220-mmHg bilateral occlusion) or a sham intervention (sham; 4 × 5-min 20-mmHg bilateral occlusion). Participants performed a graded maximal treadmill running test, followed by a 5-km time trial (TT). Brachial artery endothelial function was examined before and after RIPC or sham, as well as after the 5-km TT. We measured flowmediated dilation (FMD), an index of endothelium-dependent function, using high-resolution echo-Doppler. We also calculated the shear rate area-under-the-curve (from cuff deflation to peak dilatation; SRAUC). Data are described as mean and 95{\%} confidence intervals. FMD changed by < 0.6{\%} immediately after both ischemic preconditioning (IPC) and sham interventions (P>0.30). In the sham trial, FMD changed from 5.1 (4.4 -5.9) to 3.7{\%} (2.6-4.8) following the 5-km TT (P =0.02). In the RIPC trial, FMD changed negligibly from 5.4 (4.4-6.4) post-IPC and 5.7{\%} (4.6-6.8) post 5-km TT (P =0.60). Baseline diameter, SRAUC, and time-to-peak diameter were all increased following the 5-km TT (P < 0.05), but these changes did not influence the IPC-mediated maintenance of FMD. In conclusion, these data indicate that strenuous lower-limb exercise results in an acute decrease in brachial artery FMD of ~1.4{\%} in healthy men. However, we have shown for the first time that prior RIPC of the lower limbs maintains postexercise brachial artery endothelium-dependent function at preexercise levels.",
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Remote ischemic preconditioning prevents reduction in brachial artery flow-mediated dilation after strenuous exercise. / Bailey, Tom G.; Birk, Gurpreet K.; Timothy Cable, N.; Atkinson, Greg; Green, Daniel J.; Jones, Helen; Thijssen, Dick H.J.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 303, No. 5, 01.09.2012.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Remote ischemic preconditioning prevents reduction in brachial artery flow-mediated dilation after strenuous exercise

AU - Bailey, Tom G.

AU - Birk, Gurpreet K.

AU - Timothy Cable, N.

AU - Atkinson, Greg

AU - Green, Daniel J.

AU - Jones, Helen

AU - Thijssen, Dick H.J.

PY - 2012/9/1

Y1 - 2012/9/1

N2 - Strenuous exercise is associated with an immediate decrease in endothelial function. Repeated bouts of ischemia followed by reperfusion, known as remote ischemic preconditioning (RIPC), is able to protect the endothelium against ischemia-induced injury beyond the ischemic area. We examined the hypothesis that RIPC prevents the decrease in endothelial function observed after strenuous exercise in healthy men. In a randomized, crossover study, 13 healthy men performed running exercise preceded by RIPC of the lower limbs (4 × 5-min 220-mmHg bilateral occlusion) or a sham intervention (sham; 4 × 5-min 20-mmHg bilateral occlusion). Participants performed a graded maximal treadmill running test, followed by a 5-km time trial (TT). Brachial artery endothelial function was examined before and after RIPC or sham, as well as after the 5-km TT. We measured flowmediated dilation (FMD), an index of endothelium-dependent function, using high-resolution echo-Doppler. We also calculated the shear rate area-under-the-curve (from cuff deflation to peak dilatation; SRAUC). Data are described as mean and 95% confidence intervals. FMD changed by < 0.6% immediately after both ischemic preconditioning (IPC) and sham interventions (P>0.30). In the sham trial, FMD changed from 5.1 (4.4 -5.9) to 3.7% (2.6-4.8) following the 5-km TT (P =0.02). In the RIPC trial, FMD changed negligibly from 5.4 (4.4-6.4) post-IPC and 5.7% (4.6-6.8) post 5-km TT (P =0.60). Baseline diameter, SRAUC, and time-to-peak diameter were all increased following the 5-km TT (P < 0.05), but these changes did not influence the IPC-mediated maintenance of FMD. In conclusion, these data indicate that strenuous lower-limb exercise results in an acute decrease in brachial artery FMD of ~1.4% in healthy men. However, we have shown for the first time that prior RIPC of the lower limbs maintains postexercise brachial artery endothelium-dependent function at preexercise levels.

AB - Strenuous exercise is associated with an immediate decrease in endothelial function. Repeated bouts of ischemia followed by reperfusion, known as remote ischemic preconditioning (RIPC), is able to protect the endothelium against ischemia-induced injury beyond the ischemic area. We examined the hypothesis that RIPC prevents the decrease in endothelial function observed after strenuous exercise in healthy men. In a randomized, crossover study, 13 healthy men performed running exercise preceded by RIPC of the lower limbs (4 × 5-min 220-mmHg bilateral occlusion) or a sham intervention (sham; 4 × 5-min 20-mmHg bilateral occlusion). Participants performed a graded maximal treadmill running test, followed by a 5-km time trial (TT). Brachial artery endothelial function was examined before and after RIPC or sham, as well as after the 5-km TT. We measured flowmediated dilation (FMD), an index of endothelium-dependent function, using high-resolution echo-Doppler. We also calculated the shear rate area-under-the-curve (from cuff deflation to peak dilatation; SRAUC). Data are described as mean and 95% confidence intervals. FMD changed by < 0.6% immediately after both ischemic preconditioning (IPC) and sham interventions (P>0.30). In the sham trial, FMD changed from 5.1 (4.4 -5.9) to 3.7% (2.6-4.8) following the 5-km TT (P =0.02). In the RIPC trial, FMD changed negligibly from 5.4 (4.4-6.4) post-IPC and 5.7% (4.6-6.8) post 5-km TT (P =0.60). Baseline diameter, SRAUC, and time-to-peak diameter were all increased following the 5-km TT (P < 0.05), but these changes did not influence the IPC-mediated maintenance of FMD. In conclusion, these data indicate that strenuous lower-limb exercise results in an acute decrease in brachial artery FMD of ~1.4% in healthy men. However, we have shown for the first time that prior RIPC of the lower limbs maintains postexercise brachial artery endothelium-dependent function at preexercise levels.

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