This finding might be based on the fact that the immunological response to the extracorporeal circulation during CPB generates a systemic inflammatory response syndrome (SIRS), that is associated with the release of various pro-and anti-inflammatory cytokines[37,38] which may influence the activities of cardiac MMP-2/9, masking the RIPC-mediated effects in tissue obtained after CPB. The gene discussed is MMP2; the disease is systemic inflammatory response syndrome.