Remote Ischemic preconditioning (RIPC) has been reported to improve myocardial microcirculation, promote collateral circulation recruitment, and improve myocardial perfusion in patients.Two large randomized controlled trials demonstrated a perioperative cardioprotective effect of RIPC (reduced troponin levels), but did not find that a single preoperative RIPC improved long-term outcomes of coronary artery bypass grafting(CABG).The effect of a single RIPC before CABG may be too short. This study aims to investigate whether long-term RIPC improved myocardial perfusion in patients 3 months and 6 months after CABG surgery , and to detect changes in blood vascular endothelial growth factor, Nitrc Oxide, adenosine，and Endothelin-1, and to observe MACCE event rates at 12 months.
Three coronary artery lesions, CABG surgery was planned
The patients could not tolerate ripc;
peripheral vascular disease affecting upper limbs
Acute myocardial infarction complicated with cardiogenic shock，in recent 30 days,
Emergency cases
Parallel
remote ischemic preconditioning （RIPC）
Other interventionFour five-minute cycles of upper limb ischaemia and Four five-minute pauses using a blood pressure cuff inflated to 200 mmHg.
Change of MBF by SPECT
Myocardial perfusion was evaluated by Single Photon Emission Computed Tomography(SPECT): myocardial blood flow(MBF)
Change of MPR by SPECT
Myocardial perfusion was evaluated by Single Photon Emission Computed Tomography(SPECT): myocardial perfusion reserve(MPR)
Change of MBF by CE
Myocardial perfusion was evaluated by contrast echocardiography(CE): myocardial blood flow(MBF)
Change of MPR by CE
Myocardial perfusion was evaluated by contrast echocardiography(CE): myocardial perfusion reserve(MPR)
MBF by SPECT
Myocardial perfusion was evaluated by Single Photon Emission Computed Tomography(SPECT): myocardial blood flow(MBF)
MPR by SPECT
Myocardial perfusion was evaluated by Single Photon Emission Computed Tomography(SPECT): myocardial perfusion reserve(MPR)
MBF by CE
Myocardial perfusion was evaluated by contrast echocardiography(CE): myocardial blood flow(MBF)
MPR by CE
Myocardial perfusion was evaluated by contrast echocardiography(CE): and myocardial perfusion reserve(MPR)
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