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Therefore, therapeutic approaches limit infarct size, improving adverse remodeling and restores sympathetic innervation have a great clinical potential. Remote ischemic perconditioning (RIPerc) could markedly attenuate MI-reperfusion (MIR) injury. In this study, we aimed to assess its effects on cardiac sympathetic innervation and metabolism. Transient myocardial ischemia is induced by ligature of the left anterior descending coronary artery (LAD) in male Sprague\u2013Dawley rats, and in vivo cardiac 2-[<jats:sup>18<\/jats:sup>F]FDG and [<jats:sup>11<\/jats:sup>C]<jats:italic>m<\/jats:italic>HED PET scans were performed at 14\u201315\u00a0days after ischemia. RIPerc was induced by three cycles of 5-min-long unilateral hind limb ischemia and intermittent 5 min of reperfusion during LAD occlusion period. The PET quantitative parameters were quantified in parametric polar maps. This standardized format facilitates the regional radioactive quantification in deficit regions to remote areas. The ex vivo radionuclide distribution was additionally identified using autoradiography. Myocardial neuron density (tyrosine hydroxylase positive staining) and chondroitin sulfate proteoglycans (CSPG, inhibiting neuron regeneration) expression were assessed by immunohistochemistry. There was no significant difference in the mean hypometabolism 2-[<jats:sup>18<\/jats:sup>F]FDG uptake ratio (44.6\u2009\u00b1\u20094.8% vs. 45.4\u2009\u00b1\u20094.4%) between MIR rats and MIR\u2009+\u2009RIPerc rats (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). However, the mean [<jats:sup>11<\/jats:sup>C]<jats:italic>m<\/jats:italic>HED nervous activity of denervated myocardium was significantly elevated in MIR\u2009+\u2009RIPerc rats compared to the MIR rats (35.9\u2009\u00b1\u20097.1% vs. 28.9\u2009\u00b1\u20092.3%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), coupled with reduced denervated myocardium area (19.5\u2009\u00b1\u20095.3% vs. 27.8\u2009\u00b1\u20096.6%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), which were associated with preserved left-ventricular systolic function, a less reduction in neuron density, and a significant reduction in CSPG and CD68 expression in the myocardium. RIPerc presented a positive effect on cardiac sympathetic-nerve innervation following ischemia, but showed no significant effect on myocardial metabolism.<\/jats:p>","DOI":"10.1007\/s00395-022-00946-3","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T16:03:48Z","timestamp":1661443428000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Sympathetic nerve innervation and metabolism in ischemic myocardium in response to remote ischemic perconditioning"],"prefix":"10.1007","volume":"117","author":[{"given":"Attila","family":"Kiss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Schlederer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick M.","family":"Pilz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra Lujza","family":"Szabo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingle","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysoula","family":"Vraka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Pichler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Mitterhauser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Zins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietmar","family":"Abraham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sijin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno K.","family":"Podesser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Hacker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-6233","authenticated-orcid":false,"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"issue":"11","key":"946_CR1","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1007\/s00259-017-3760-y","volume":"44","author":"T Aikawa","year":"2017","unstructured":"Aikawa T, Naya M, Obara M, Oyama-Manabe N, Manabe O, Magota K, Ito YM, Katoh C, Tamaki N (2017) Regional interaction between myocardial sympathetic denervation, contractile dysfunction, and fibrosis in heart failure with preserved ejection fraction: (11)C-hydroxyephedrine PET study. 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