Application of Remote Ischemic Preconditioning in Patients Undergoing Chemotherapy with Anthracyclines | Bentham Science

摘要

Background: The most active agents for the treatment of breast cancer are the anthracyclineswhose clinical usefulness is limited by cumulative dose-dependent cardiotoxicity, which resultsin congestive heart failure among other limiting factors. With all the attempts to minimizechemotherapeutic cardiotoxicity, remote ischemic preconditioning (RIPC) has been considered as apotent endogenous mechanism capable of inhibiting inflammatory responses.Objective: This study aimed to verify if RIPC may be effective as prophylaxis to prevent anthracycline-induced cardiotoxicity in oncological patients.Methods: The preconditioning method was based on four to five-minute cycles of a blood pressurecuff insufflation around the upper arm (either left or right) from 200 mmHg to 250 mmHg, inducingischemic intervals interspersed with 5 minutes of reperfusion.Results: In this work, echocardiogram results showed a ventricular mass variation that can get worseduring chemotherapeutic treatment; however, in patients who had been undergoing RIPC sessionsover a period of 6 months, it was observed that this change did not occur. The parameters for troponinT levels were considered; they were higher in patients who were not undergoing RIPC in relationto those who were. When both cases were compared, it was possible to infer that there was aclinically significant improvement for those who went through the procedure.Conclusion: Thus, through the analysis of this study, it is possible to conclude that RIPC is a lowcost,non-invasive procedure which brings cardiac protection for patients undergoing chemotherapywith anthracyclines, providing support in the treatment of cancer.