Seven consecutive days of remote ischaemic preconditioning improves cutaneous vasodilatory capacity in young adults

Remote ischaemic preconditioning (RIPC), induced by intermittent periods of ischaemia followed by reperfusion, confers cardiovascular protection from subsequent ischaemic bouts. RIPC increases conduit and resistance vessel function; however, the effect of RIPC on the microvasculature remains unclear. Using human skin as a microvascular model, we hypothesized that cutaneous vasodilatory (VD) function elicited by localized heating would be increased following repeated RIPC. Ten participants (23 1years, 6 males, 4 females) performed RIPC for seven consecutive days. Each daily RIPC session consisted of 4 repetitions of 5min of arm blood flow occlusion interspersed by 5min reperfusion. Before, 1day after and 1week after the 7days of RIPC, two microdialysis fibres were placed in ventral forearm skin for continuous infusion of Ringer solution or 20mM l-NAME. Red blood cell flux was measured by laser Doppler flowmetry at each fibre site during local heating (T-loc= 39 degrees C) and during maximal VD elicited by heating (T-loc= 43 degrees C) and 28mM sodium nitroprusside infusion. Data were normalized to cutaneous vascular conductance (flux/mmHg). Seven days of RIPC did not alter the nitric oxide (NO) contribution to the VD response to local heating (P> 0.05). However, the maximal VD was augmented (Pre: 2.5 0.2, Post: 3.8 0.5flux/mmHg; P< 0.05) and remained elevated 1week post RIPC (3.3 0.4flux/mmHg; P< 0.05). Repeated RIPC improves maximal VD but does not affect NO-mediated VD in the cutaneous microvasculature. This finding suggests that other factors may explain the vasodilatory adaptations that occur following repeated RIPC.