Pilot Study Examining the Effects of Remote Ischaemic Preconditioning on Arterial Stiffness and Endothelial Function in Patients with Peripheral Arterial Disease

  • Damian Smith

    Student thesis: Master's ThesisMaster of Science

    Abstract

    Background: Intermittent Claudication (IC) is pain on walking that is related to poor blood supply to the lower limbs. Endothelial dysfunction is thought to play a role in the onset and progression of this condition. The idea that short periods of non-lethal ischaemia followed by periods of reperfusion, in one organ or tissue, triggers endogenous protective pathways in other organs is known as Remote Ischaemic Preconditioning (RIPC). RIPC has been shown to improve endothelial function by increasing bioavailability of NO. The study aims to evaluate whether RIPC can improve markers of vascular function by assessing its effect in participants with IC compared to healthy volunteers.

    Methods: Seventeen participants were recruited and underwent four days of RIPC protocol. Vascular function was assessed using (i) iontophoresis with Laser Doppler Imaging (LDI), (ii) Post occlusive reactive hyperaemia test (PORH) (iii) pulse wave analysis (PWA) and pulse wave velocity (PWV) to measure arterial stiffness. Blood samples were also taken to assess for any change in serum cytokines and markers of oxidative stress.

    Results: Multiple regression analysis demonstrated a statistically significant improvement in PWA, after RIPC intervention, in healthy volunteers only (p ≤ 0.05 is used as statistical significance). There were no other significant predictors of change in vascular function after RIPC.

    Conclusion: RIPC appears to show improvement in arterial stiffness as measured by PWA. The results suggest that RIPC has a greater beneficial effect in healthy volunteers as opposed to patients with IC. The results do not support the idea that improvements in vascular function are solely mediated through improvement in endothelial function.
    Date of Award2021
    Original languageEnglish
    SupervisorFaisel Khan (Supervisor) & Stuart Suttie (Supervisor)

    Keywords

    • Endothelial
    • Function
    • Ischaemic
    • Preconditioning
    • Remote
    • Arterial
    • Disease
    • Peripheral

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