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11 Acute hyperglycemia abolishes cardioprotection by remote ischemic perconditioning {#article-title-2} Background: Remote ischemic perconditioning (RIPerC) has a promising therapeutic value to improve prognosis of acute myocardial infarction. Chronic comorbidities such as diabetes are known to interfere with conditioning interventions by modulating cardioprotective signaling pathways, such as e.g. autophagy. However, the effect of acute hyperglycemia on RIPerC has not been studied so far. Therefore, here we investigated the effect of acute hyperglycemia on the cardioprotective effect of RIPerC. Methods: Wistar rats were divided into normoglycemic (NG) and acute hyperglycemic (AHG) groups. Acute hyperglycemia was induced by glucose infusion to maintain a serum glucose concentration of 15 to 20 mM throughout the experimental protocol. NG rats received mannitol infusion of an equal osmolarity. Both groups were subdivided into an ischemic (Isch) and a RIPerC group. Each group underwent reversible occlusion of the left anterior descending coronary artery (LAD) for 40 min in the presence or absence of acute hyperglycemia. After 10 min LAD occlusion, RIPerC was induced by 3 cycles of 5 min unilateral femoral artery and vein occlusion and 5 min reperfusion. After 120 min reperfusion, infarct size was measured by triphenyltetrazolium chloride staining.To study underlying signaling mechanisms, hearts were harvested for immunoblotting after 35 min in both the NG and AHG groups. Results: Infarct size was significantly reduced by RIPerC in NG, but not in the AHG group (NG+Isch: 46.27±5.31% vs. NG+RIPerC: 24.65±7.45%, p