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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ekeloef, S. Larsen, M. H. H. Schou-Pedersen, A. M. V. Lykkesfeldt, J. Rosenberg, J. Gögenür, I. |
| Description | Country affiliation: Denmark Author Affiliation: Ekeloef S ( Centre for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebækvej1, 4600 Koege, Denmark savb@regionsjaelland.dk.); Larsen MH ( Centre for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebækvej1, 4600 Koege, Denmark.); Schou-Pedersen AM ( Faculty of Health & Medical Sciences, University of Copenhagen, Ridebanevej 9, Frederiksberg 1870, Denmark.); Lykkesfeldt J ( Faculty of Health & Medical Sciences, University of Copenhagen, Ridebanevej 9, Frederiksberg 1870, Denmark.); Rosenberg J ( Center for Perioperative Optimization, Department of Surgery, Herlev University Hospital, Herlev Ringvej 75, Herlev 2730, Denmark.); Gögenür I ( Centre for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebækvej1, 4600 Koege, Denmark.) |
| Abstract | BACKGROUND: Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide pathway postoperatively. METHODS: Patients undergoing elective colon cancer surgery (n = 31) were included in this prospective observational cohort study. Endothelial function, as measured using the reactive hyperaemia index (RHI), was assessed non-invasively using digital pulse tonometry. RHI and plasma concentrations of L-arginine, asymmetric dimethylarginine (ADMA), dihydrobiopterin and biopterin metabolites, tetrahydrobiopterin (BH4) and total biopterin were measured before surgery, at four h after surgery and at postoperative day one and two. Cardiac troponin I was measured before surgery and once daily on postoperative days one to four. RESULTS: Preoperative RHI was 1.86 (1.64 - 2.11) and decreased significantly during the observation period (linear mixed effects model of serial measurements, P = 0.015). Both L-arginine (P < 0.001) and ADMA (P = 0.024) decreased during the postoperative period. All biopterin metabolites were significantly decreased after surgery. A significant positive correlation was found between logAUC(l-arginine/ADMA) and logAUC(RHI) (P = 0.015) and between logAUC(L-arginine/ADMA) and logAUC(BH4) (P = 0.015). None of the patients had cardiac troponin I elevations. CONCLUSIONS: RHI was attenuated in the first days after colon cancer surgery indicating acute endothelial dysfunction. Endothelial dysfunction correlated with disturbances in the L-arginine - nitric oxide pathway. Our findings provide a rationale for investigating the hypothesized association between acute endothelial dysfunction and cardiovascular complications after non-cardiac surgery. CLINICAL TRIAL REGISTRATION: NCT02344771. |
| File Format | HTM / HTML |
| ISSN | 00070912 |
| e-ISSN | 14716771 |
| Journal | British Journal of Anaesthesia |
| Issue Number | 2 |
| Volume Number | 118 |
| Language | English |
| Publisher | Oxford University Press |
| Publisher Date | 2017-02-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Anaesthesia |
| Content Type | Text |
| Resource Type | Article |
| Subject | Anesthesiology and Pain Medicine |
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