The mechanisms underlying the protective effects of remote ischemic preconditioning (RIPC) are not presently clear. Recent studies in experimental models suggest the involvement of the autonomic nervous system (ANS) in cardioprotection. The aim of this study was to investigate the changes in ANS in healthy young volunteers divided into RIPC (n = 22) or SHAM (n = 18) groups. RIPC was induced by 1 cycle of 4 min inflation/5 min deflation followed by 2 cycles of 5 min inflation/5 min deflation of a cuff placed on the upper left limb. The study included analysis of heart rate (HR), blood pressure (BP), heart rate variability (HRV), measurements of microcirculation and porphyrin fluorescence in the limb before and after the RIPC. RIPC caused reactive hyperemia in the limb and reduced blood porphyrin level. A mental load (serial sevens test) and mild motor stress (hyperventilation) were performed on all subjects before and after RIPC or corresponding rest in the SHAM group. Reduction of HR occurred during the experiments in both RIPC and SHAM groups reflecting RIPC-independent adaptation of the subjects to the experimental procedure. However, in contrast to the SHAM group, RIPC altered several of the spectral indices of HRV during the serial sevens test and hyperventilation. This was expressed predominantly as an increase in power of the very low-frequency band of the spectrum, increased values of detrended fluctuation analysis and weakening of correlation between the HRV parameters and HR. In conclusion, RIPC induces changes in the activity of ANS that are linked to stress resistance.

目前尚不清楚远程缺血预处理 (RIPC) 保护作用的潜在机制。最近对实验模型的研究表明自主神经系统 (ANS) 参与了心脏保护。本研究的目的是调查分为 RIPC (n = 22) 或 SHAM (n = 18) 组的健康年轻志愿者的 ANS 变化。RIPC 由 1 个循环 4 分钟充气/5 分钟放气，然后是 2 个循环 5 分钟充气/5 分钟放气，放置在左上肢的袖带。该研究包括分析心率 (HR)、血压 (BP)、心率变异性 (HRV)，测量 RIPC 前后肢体的微循环和卟啉荧光。RIPC 引起肢体反应性充血和血卟啉水平降低。在 SHAM 组中，在 RIPC 或相应休息之前和之后，对所有受试者进行精神负荷（连续七人小组测试）和轻度运动压力（过度换气）。HR 在 RIPC 和 SHAM 组的实验过程中都发生了降低，这反映了受试者对实验程序的独立于 RIPC 的适应。然而，与 SHAM 组相比，RIPC 在连续七人小组测试和过度通气期间改变了几个 HRV 的光谱指数。这主要表现为频谱极低频段的功率增加、去趋势波动分析值增加以及 HRV 参数与 HR 之间的相关性减弱。总之，RIPC 会引起与抗压性相关的 ANS 活性的变化。