Using Blood Pressure Cuff Right Before Heart Surgery Cuts Heart Damage: Study

Procedure is safe, cheap and simple, researchers say

By Robert Preidt

Friday, August 16, 2013

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FRIDAY, Aug. 16 (HealthDay News) -- Inflating a blood pressure cuff on a patient's upper arm just before heart bypass surgery reduces heart damage and may improve long-term survival, according to a new study.
This practice, called "remote ischemic preconditioning," involves using the blood pressure cuff to briefly cut off, and then restore, blood supply to an area of the body distant from the heart, such as the arm.
The study appears in the Aug. 17 issue of The Lancet.
Heart muscle damage is a common consequence of complex heart procedures such as bypass surgery and is associated with poorer long-term survival and health problems such as heart attack, according to a journal news release.
This study included 162 patients who had remote ischemic preconditioning before heart bypass surgery. A blood pressure cuff was inflated on their left upper arm, restricting blood supply for five minutes, followed by five minutes of normal blood flow. This was repeated three times.
These patients were compared to a control group of 167 patients who did not undergo the procedure before heart bypass surgery.
Following surgery, the researchers measured the patients' blood concentrations of troponin I, a protein that indicates heart muscle damage. Higher concentrations indicate more damage. Seventy-two hours after surgery, troponin levels were an average of 17 percent lower among patients who had remote ischemic conditioning than among those in the control group.
The researchers also followed patients for up to four years to determine if remote preconditioning had any effect on long-term health. One year after surgery, patients who had remote ischemic preconditioning were 73 percent less likely to have died of any cause, and 86 percent less likely to have died from heart attack or stroke, compared to those in the control group.
"The results of our study are very encouraging that remote ischemic preconditioning not only reduces heart muscle injury but also improves long-term health outcomes for heart bypass patients, and we hope that these benefits will be confirmed in larger prospective studies which are currently taking place," study co-leader Professor Gerd Heusch, of the University School of Medicine Essen in Germany, said in the news release.
Dr. Matthias Thielmann, also of the University School of Medicine Essen, said remote ischemic preconditioning is noninvasive, cheap and safe. "This procedure could be a promising and simple strategy to protect patients' heart muscle during surgery and hopefully improve health outcomes after surgery," he said in the news release.

SOURCE: The Lancet, news release, Aug. 15, 2013

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