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To observe acute hemodynamic effects of the remote ischemic preconditioning on the coronary perfusion pressure and coronary collateral blood flow.
Nine patients with coronary heart disease of one or two-vessel severe stenosis confirmed by angiography were randomly enrolled in the self-control study. Firstly, before interventional treatment a lower limb ischemia-reperfusion preconditioning was made by oppression of a blood-pressure cuff inflated above the knee to a degree of blood flow occluded totally in dorsalis pedis artery for 10 minutes, and then reperfusion for 5 minutes. Coronary artery stenosis proximal and distal pressure(non-occlusive pressure) and distal coronary artery occlusive pressure during balloon dilation occlusion were measured before and after the lower limb ischemia-reperfusion preconditioning, and collateral flow index was calculated through a formula: occlusive pressure / non-occlusive pressure×100%.
Compared with the distal target vessel occlusive pressure (occlusive pressure) measured before remote ischemic preconditioning, the pressure after remote ischemic preconditioning was significantly increased（mean occlusive pressure 26.78 ± 10.73 mmHg vs 20.89 ± 8.61mmHg (p = 0.001)）. The pressure of target vessel distal to the stenosis (non-occlusive pressure) increased significantly after remote ischemic preconditioning and the ratios of occlusive pressure / non-occlusive pressure significantly improved. Collateral flow index increased from 28.78 ± 11.42% to 34.00 ± 11.38% (p = 0.001).
RIPC can improve distal coronary perfusion pressure, rapidly increase distal coronary occlusive pressure and improve coronary collateral blood flow. The formula we designed as occlusive pressure / non-occlusive pressure×100% for calculating the index of collateral blood flow is demonstrated ideal, practical and meaningful.