Introduction: In heterochronic parabiosis, young and old rats are conjoined, allowing for the exchange of young (or healthy) and old (or unhealthy) factors. Heart conditioning involves stress on the heart, triggering compensatory mechanisms that release cardioprotective (or healthy) factors and eliminate unhealthy factors. Both models optimize the extracellular fluid and physiological processes, leading to cardiac reverse remodeling and the reversal of disease and aging. Heart conditioning and heterochronic parabiosis are correlated and can be used as healthy medicine to reverse disease and aging. This study investigates the effects of Remote Ischemic Conditioning (RIC) on cardiac remodeling in patients with cardiac enlargement and heart failure.

Methods: Forty-four patients with cardiac enlargement were prospectively enrolled and randomly divided into RIC group (n=22) and control group (n=22). Additionally, forty patients with stable heart failure were prospectively enlisted and randomly divided into RIC (n=20) and control (n=20) groups. The RIC protocol involves a 3-minute inflation and deflation of the blood pressure cuff attached to the upper arm to produce transient ischemia of the arm. RIC treatment was performed once daily for one year. NYHA class, Left Ventricular Ejection Fraction (LVEF), left atrial and ventricular dimensions were all assessed in both groups.

Results: RIC treatment was well-tolerated. After one year of treatment, left atrial and ventricular dimensions were significantly decreased in the RIC group. Moreover, NYHA class improved and LVEF showed a significant increase from 37.11% to 52.44% (p < 0.0001) in the RIC group.

Conclusion: The study suggests that a one-year course of RIC treatment as healthy medicine could reverse cardiac enlargement and improve cardiovascular function in heart failure patients through the process of cardiac reverse remodeling, supporting the widespread use of RIC in the daily lives of these patients as adjunctive therapy.

Andrew Ying Siu Lee is a consultant cardiologist and associate professor with a strong educational background and extensive experience in the field of medicine, geriatrics and physiology. As a highly qualified physician, he holds multiple medical qualifications and specialist designations from the Ministry of Health in Taiwan. He is also a member of the German Chamber of Physicians and hold an ECFMG medical certificate from the USA. His expertise in internal medicine, cardiology, intensive care, geriatrics and interventional cardiology makes me a well-rounded and versatile medical professional. In addition to his impressive credentials, he has also received numerous honors and awards including scholarships from the University of Hong Kong and the prestigious DAAD scholarship from Germany. He has also been recognized for his contributions to the field by being included in Marquis Who’s Who in the World and Marquis Who’s Who in science and engineering. With his expertise experience and passion for healthcare, he continues to make a significant impact in the medical community. He has served as a distinguished reviewer for various reputable journals, including Acta Cardiol Sin, Pharmacol Toxicol, Clinical Experimental Pharmacol Physio, BMJ Case Reports, J Intl Medical Research, Exp Gerontol and Current Stem Cell Research Therapy. Committed to advancing scientific knowledge and improving healthcare, he remains actively involved in research, publications, and academic and professional endeavors. He has invented what is currently the only effective healthy regimen worldwide. Its mechanism is that heart conditioning provides external pressure as stressor, which can elicit the body’s compensatory mechanism, release healthy factors such as cardioprotective factors, and remove unhealthy factors such as free radicals, etc., improve extracellular fluid, and lead to cardiac reverse remodeling conducive to reversing disease and aging, consistent with the heterochronic parabiotic model.