TY - JOUR
T1 - Effect of Remote Ischemic Conditioning on the Form and Function of Red Blood Cells in Patients with Acute Ischemic Stroke
AU - Blauenfeldt, Rolf Ankerlund
AU - Waller, Jennifer
AU - Drasbek, Kim Ryun
AU - Bech, Jesper Nørgaard
AU - Hvas, Anne Mette
AU - Larsen, Julie Brogaard
AU - Andersen, Morten Nørgaard
AU - Nielsen, Marlene Christina
AU - Kjølhede, Maria
AU - Kjeldsen, Mathilde
AU - Gude, Martin Faurholdt
AU - Khan, Mohammad Badruzzaman
AU - Baban, Babak
AU - Andersen, Grethe
AU - Hess, David Charles
PY - 2025/3/1
Y1 - 2025/3/1
N2 - BACKGROUND: Remote ischemic conditioning (RIC) is a simple and low-cost intervention that is thought to increase collateral blood flow through the vasodilatory effects of nitric oxide (NO) produced by the endothelium and red blood cells (RBCs). This study aims to investigate whether RIC affects RBC deformability and levels of NO and nitrite in patients with ischemic stroke. METHODS: This is a predefined substudy to the RESIST (Remote Ischemic Conditioning in Patients With Acute Stroke Trial) randomized clinical trial conducted in Denmark. RIC was started in the ambulance and continued at the hospital for seven days. Blood samples were collected at different time points: prehospital in the ambulance, in-hospital upon arrival, 2 hours postadmission, and 24 hours postadmission. RBC deformability and erythrocyte aggregation rate were assessed using ektacytometry, NO using flowcytometry, and nitrite content using ozone chemiluminescence. RESULTS: Of 1500 prehospital randomized patients, 486 patients were included in this study between July 28, 2020, and November 11, 2023, and had blood samples taken. Of these, 249 (51%) had AIS, and here RIC treatment was not associated with increased RBC maximal deformability (RIC, 0.549; sham, 0.548; P=0.31), RBC NO (RIC, 35 301 median fluorescence intensity; sham, 34979 median fluorescence intensity; P=0.89), or nitrite (RIC, 0.036 µmol/L; sham, 0.034 µmol/L; P=0.38), but RIC treatment was associated with a significantly reduced aggregation pressure and a slower erythrocyte aggregation rate (RIC, 323.76 millipascal; sham, 352.74 millipascal; P=0.0113). CONCLUSIONS: Prehospital and in-hospital RIC significantly reduced erythrocyte aggregation rate in patients with acute ischemic stroke, while there was no change in RBC deformability, NO content, or whole blood nitrite levels.
AB - BACKGROUND: Remote ischemic conditioning (RIC) is a simple and low-cost intervention that is thought to increase collateral blood flow through the vasodilatory effects of nitric oxide (NO) produced by the endothelium and red blood cells (RBCs). This study aims to investigate whether RIC affects RBC deformability and levels of NO and nitrite in patients with ischemic stroke. METHODS: This is a predefined substudy to the RESIST (Remote Ischemic Conditioning in Patients With Acute Stroke Trial) randomized clinical trial conducted in Denmark. RIC was started in the ambulance and continued at the hospital for seven days. Blood samples were collected at different time points: prehospital in the ambulance, in-hospital upon arrival, 2 hours postadmission, and 24 hours postadmission. RBC deformability and erythrocyte aggregation rate were assessed using ektacytometry, NO using flowcytometry, and nitrite content using ozone chemiluminescence. RESULTS: Of 1500 prehospital randomized patients, 486 patients were included in this study between July 28, 2020, and November 11, 2023, and had blood samples taken. Of these, 249 (51%) had AIS, and here RIC treatment was not associated with increased RBC maximal deformability (RIC, 0.549; sham, 0.548; P=0.31), RBC NO (RIC, 35 301 median fluorescence intensity; sham, 34979 median fluorescence intensity; P=0.89), or nitrite (RIC, 0.036 µmol/L; sham, 0.034 µmol/L; P=0.38), but RIC treatment was associated with a significantly reduced aggregation pressure and a slower erythrocyte aggregation rate (RIC, 323.76 millipascal; sham, 352.74 millipascal; P=0.0113). CONCLUSIONS: Prehospital and in-hospital RIC significantly reduced erythrocyte aggregation rate in patients with acute ischemic stroke, while there was no change in RBC deformability, NO content, or whole blood nitrite levels.
KW - erythrocytes
KW - ischemic stroke
KW - nitric oxide
KW - nitrites
UR - http://www.scopus.com/inward/record.url?scp=85216954742&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.124.048976
DO - 10.1161/STROKEAHA.124.048976
M3 - Journal article
C2 - 39882626
AN - SCOPUS:85216954742
SN - 0039-2499
VL - 56
SP - 603
EP - 612
JO - Stroke
JF - Stroke
IS - 3
ER -