Experimental setting. RIPC was performed by 4 cycles of 5 minutes of upper arm ischemia induced with a blood pressure cuff which was inflated to 200 mmHg. Each cycle of ischemia was followed by 5 minutes of reperfusion. In the control group 4 cycles of 5-minutes blood-pressure cuff inflation to 20 mmHg and 5-minutes cuff deflation were applied. Cardiac biopsies were obtained before and after CPB. CPB, cardiopulmonary bypass; RIPC, remote ischemic preconditioning.