The main aim of the current study is to assess cardiovascular effects of remote ischemic conditioning in patients who have suffered from stroke. A group of stroke patients will be subjected to four weeks of daily remote ischemic conditioning and four weeks of placebo and vascular function is assessed as a primary outcome.
Remote ischemic preconditioning (RIC) has been shown to reduce myocardial damage in association with a myocardial infarct but less is known about the potential effects on vascular function in patients who have suffered a stroke. RIC is a procedure by which blood flow to a limb is repeatedly occluded during a short period by an inflatable cuff. This project evaluates the effect of a two week period with RIC on vascular function and cerebral blood flow velocity as well as on factors associated with blood clot formation in patients who have suffered a stroke. The study also aims to provide mechanistic insight into the beneficial effects of the RIC procedure. Subjects are patients who within the past five years have suffered from lacunar infarct. The study is of a cross-over design with two weeks of homebased RIC treatment and two weeks of control period in a randomized order. Before and after the experimental periods the subjects undergo a number of tests assessing general health status, vascular function and cerebral blood flow velocity. Skeletal muscle samples are obtained for the determination of selected proteins related to vascular function and angiogenesis and blood samples are obtained for the determination of platelet function. .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
30
Four weeks of daily ischemic conditioning and four weeks of sham ischemic conditioning in a cross over design
University of Copenhagen
Copenhagen, Denmark
Department of Neurology, Herlev Hospital
Herlev, Denmark
Flow mediated dilation
Assessment of brachial artery dilation after 5 min occlusion of upper arm by cuff
Time frame: Change from baseline to 4 weeks
Cerebral vascular function-visual task
Assessment of change in cerebral blood flow velocity with visual task
Time frame: Change from baseline to 4 weeks
Cerebral vascular function- motorparadigm task
Assessment of change in cerebral blood flow velocity with motorparadigm task
Time frame: Change from baseline to 4 weeks
Skeletal muscle blood flow
Femoral arterial blood flow measured at rest and during one leg knee extensor exercise
Time frame: Change from baseline to 4 weeks
Platelet reactivity
Platelet reactivity is assessed in platelets isolated from blood samples
Time frame: Change from baseline to 4 weeks
Blood clot structure-gel point
Blood clot structure is assessed by gel point
Time frame: Change from baseline to 4 weeks
Blood clot structure-fractal analysis
Blood clot structure is assessed by fractal analysis
Time frame: Change from baseline to 4 weeks
Skeletal muscle proteins
Proteins associated with angiogenesis and vascular function are assessed in skeletal muscle samples obtained from the thigh muscle
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Time frame: Change from baseline to 4 weeks
Plasma proteins
Protein amount is determined in plasma
Time frame: Change from baseline to 4 weeks
Plasma lipids
Lipid concentration is determined in plasma
Time frame: Change from baseline to 4 weeks
Oral glucose tolerance test (OGTT)
An oral glucose tolerance test is conducted by assesment of blood glucose and insulin before and after ingestion of glucose
Time frame: Change from baseline to 4 weeks
Body composition
Body composition is assessed by dual energy x-ray absorptiometry
Time frame: Change from baseline to 4 weeks