Seven day remote ischaemic preconditioning improves endothelial function in patients with type 2 diabetes mellitus: a randomised pilot study
| Autor: | Howard H. Carter, Helen Jones, Joseph D. Maxwell, Gemma D Miller, Dick H. J. Thijssen, Ylva Hellsten, Victoria S. Sprung, Daniel J. Cuthbertson |
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| Jazyk: | angličtina |
| Předmět: |
Male
medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Pilot Projects 030209 endocrinology & metabolism Cerebral autoregulation law.invention 03 medical and health sciences 0302 clinical medicine Endocrinology All institutes and research themes of the Radboud University Medical Center Forearm Randomized controlled trial law RA0421 Internal medicine Diabetes mellitus Faculty of Science medicine Humans Ischemic Preconditioning Remote ischaemic preconditioning Aged QM business.industry Type 2 Diabetes Mellitus Type 2 diabetes General Medicine Vascular function Middle Aged medicine.disease Peripheral medicine.anatomical_structure Diabetes Mellitus Type 2 Sample size determination Reperfusion Injury 030220 oncology & carcinogenesis Ischaemia reperfusion injury Cardiology Female business RA Artery |
| Zdroj: | European Journal of Endocrinology, 181, 6, pp. 659-669 European Journal of Endocrinology, 181, 659-669 Maxwell, J D, Carter, H H, Hellsten, Y, Miller, G D, Sprung, V S, Cuthbertson, D J, Thijssen, D H J & Jones, H 2019, ' Seven day remote ischaemic preconditioning improves endothelial function in patients with type 2 diabetes mellitus : a randomised pilot study ', European Journal of Endocrinology, vol. 181, no. 6, pp. 659-669 . https://doi.org/10.1530/EJE-19-0378 |
| ISSN: | 0804-4643 |
| DOI: | 10.1530/EJE-19-0378 |
| Popis: | Background Remote ischaemic preconditioning (rIPC) may improve cardiac/cerebrovascular outcomes of ischaemic events. Ischaemic damage caused by cardiovascular/cerebrovascular disease are primary causes of mortality in type 2 diabetes mellitus (T2DM). Due to the positive effects from a bout of rIPC within the vasculature, we explored if daily rIPC could improve endothelial and cerebrovascular function. The aim of this pilot study was to obtain estimates for the change in conduit artery and cerebrovascular function following a 7-day rIPC intervention. Methods Twenty-one patients with T2DM were randomly allocated to either 7-day daily upper-arm rIPC (4 × 5 min 220 mmHg, interspaced by 5-min reperfusion) or control. We examined peripheral endothelial function using flow mediated dilation (FMD) before and after ischemia-reperfusion injury (IRI, 20 min forearm ischaemic-20 min reperfusion) and cerebrovascular function, assessed by dynamic cerebral autoregulation (dCA) at three time points; pre, post and 8 days post intervention. Results For exploratory purposes, we performed statistical analysis on our primary comparison (pre-to-post) to provide an estimate of the change in the primary and secondary outcome variables. Using pre-intervention data as a covariate, the change from pre-post in FMD was 1.3% (95% CI: 0.69 to 3.80; P = 0.09) and 0.23 %cm/s %/mmHg mmHg/% (−0.12, 0.59; P = 0.18) in dCA normalised gain with rIPC versus control. Based upon this, a sample size of 20 and 50 for FMD and normalised gain, respectively, in each group would provide 90% power to detect statistically significant (P Conclusion We provide estimates of sample size for a randomised control trial exploring the impact of daily rIPC for 7 days on peripheral endothelial and cerebrovascular function. The directional changes outline from our pilot study suggest peripheral endothelial function can be enhanced by daily rIPC in patients with T2DM. |
| Databáze: | OpenAIRE |
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