Experimental Study On The Protective Effect Of Combined Vagus Nerve Stimulation Perconditioning And Limb Remote Ischemic Perconditioning Against Myocardial Ischemia Reperfusion Injury In Rats In Vivo

Various combined interventions to acquire enhanced cardioprotection are prevalent focuses of current research.This randomized experiment assessed whether combined vagal stimulation perconditioning(VSPerC)and limb remote ischemic perconditioning(LRIPerC)improved cardioprotectioncompared to the use of either treatment alone in an in vivo rat model of myocardial ischemia/reperfusioninjury.A total of 100 male Sprague Dawley rats were randomly allocated into five groups:sham group,ischemia/reperfusion(IR)group,VSPerC group,LRIPerC group,and combined VSPerC and LRIPerC(COMPerC)group.Serum enzymatic markers,inflammatory cytokines,myocardial inflammatorycytokines,and infarct size were assessed.Infarct size decreased significantly in the COMPerC groupcompared to the VSPerC and LRIPerC groups.Serum intercellular adhesion molecule 1(ICAM-1)levelat 120 min of reperfusion,myocardial interleukin-1(IL-1),ICAM-1,and tumor necrosis factor α(TNF-α)levels in the ischemic region decreased significantly in the COMPerC group compared tothe VSPerC group,but myocardial IL-10 levels in the nonischemic region increased markedly in theCOMPerC group.Serum TNF-α levels at 30,60,and 120 min of reperfusion;serum IL-1,IL-6,ICAM-1,and high mobility group box-1 protein(HMGB-1)levels at 120 min of reperfusion;andmyocardial IL-1,IL-6,ICAM-1,and TNF-α levels in the ischemic region decreased significantly inthe COMPerC group compared to the LRIPerC group.However,myocardial IL-10 levels in bothischemic and nonischemic regions were evidently higher in the COMPerC group.This studyconcludes that combined VSPerC and LRIPerC enhances cardioprotection compared to eithertreatment alone.This result is likely attributable to a more potent regulation of inflammation.