{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:34:12Z","timestamp":1789205652651,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,5,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Our previous randomized controlled trial demonstrated cardiorespiratory protection by remote ischemic preconditioning (\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              ) in children before cardiac surgery. However, the impact of\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              on myocardial prosurvival intracellular signaling remains unknown in cyanosis.\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              may augment phosphorylated protein signaling in myocardium and circulating leukocytes during tetralogy of\n              <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>\n              allot (ToF) repair.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Children (n=40) undergoing ToF repair were double\u2010blind randomized to\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              (n=11 boys, 9 girls) or control (sham\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              : n=9 boys, 11 girls). Blood samples were taken before, immediately after, and 24\u00a0hours after cardiopulmonary bypass. Resected right ventricular outflow tract muscle and leukocytes were processed for protein expression and mitochondrial respiration. There was no difference in age (7.1\u00b13.4 versus 7.1\u00b13.4\u00a0months), weight (7.7\u00b11.8 versus 7.5\u00b11.9\u00a0kg), or bypass or aortic cross\u2010clamp times between the groups (control versus\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              , mean\u00b1\n              <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n              ). No differences were seen between the groups for an increase in the ratio of phosphorylated to total protein for protein kinase B, p38 mitogen activated protein kinase, signal transducer and activator of transcription 3, glycogen synthase kinase 3\u03b2, heat shock protein 27, Connexin43, or markers associated with promotion of necrosis (serum cardiac troponin I), apoptosis (Bax, Bcl\u20102), and autophagy (Parkin, Beclin\u20101, LC3B). A high proportion of total proteins were in phosphorylated form in control and\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              myocardium. In leukocytes, mitochondrial respiration and assessed protein levels did not differ between groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In patients with cyanotic heart disease, a high proportion of proteins are in phosphorylated form.\n              <jats:styled-content style=\"fixed-case\">RIPC<\/jats:styled-content>\n              does not further enhance phosphorylated protein signaling in myocardium or circulating leukocytes in children undergoing ToF repair.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL: (\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.anzctr.org.au\/trial_view.aspx?id=335613\">http:\/\/www.anzctr.org.au\/trial_view.aspx?id=335613<\/jats:ext-link>\n              . Unique identifier: Australian New Zealand Clinical Trials Registry number ACTRN12610000496011.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000095","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T16:50:13Z","timestamp":1369414213000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Effect of Remote Ischemic Preconditioning on Phosphorylated Protein Signaling in Children Undergoing Tetralogy of Fallot Repair: A Randomized Controlled Trial"],"prefix":"10.1161","volume":"2","author":[{"given":"Salvatore","family":"Pepe","sequence":"first","affiliation":[{"name":"Heart Research Group, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman 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Melbourne, Australia"},{"name":"Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"d'Udekem","sequence":"additional","affiliation":[{"name":"Heart Research Group, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Australia"},{"name":"Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Heart Research Group, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Australia"},{"name":"Department of Cardiology, Royal Children's Hospital, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor E.","family":"Konstantinov","sequence":"additional","affiliation":[{"name":"Heart Research Group, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Australia"},{"name":"Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, 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