Relationships between perioperative vascular endothelial function and cardiovascular changes

WU Meng-jun; WEI An-ning; XU Ping; HU Yan-jun; YIN Yu-hui; HU Jin-sheng

摘要：Background Perioperative cardiovascular complications occurred frequently, especially coronary heart disease, as atherosclerosis risk factors in patients. To explore the perioperative arterial vascular endothelial function and carotid intima-media thickness (IMT) as atherosclerosis early pathological changes of alternative indicators forecast the possibility of cardiovascular complications. Methods We selected surgery patients 150 cases: including atherosclerosis risk factors group (ASF group): 73 cases, among them, 22 cases had carotid artery atherosclerosis plaque (ASF: IMT Plaque) and 51 cases had no plaque (ASF: NO-IMT Plaque); and nonrisk factors group (NO-ASF group): 77 cases, among them, 18 cases had carotid artery atherosclerosis plaque (NO-ASF: IMT Plaque) and 59 cases had no plaque (NO-ASF: NO-IMT Plaque). Arterial vascular endothelial function was measured as flow-mediated dilation (FMD) of the brachial artery using lugh-resolution B-mode ultrasonic device, for one day before operation (the baseline of value), on two hours from recovery after general anesthesia, the first day after operation, the fifth days after operation. Results FMD of two groups on two hours was reduced, compared with the baseline, but FMD of ASF group was decreased significantly (P = 0.032); FMD of ones further was mcreased on Day 1 and Day 5, but NO-ASF group was increased significantly (P < 0.05);FMD of the baseline and atherosclerosis risk factors was negatively correlated (R = -0.216, P = 0.023). FMD of ASF: IMTP group was decreased significantly respectively in four times, compared with the ASF:NO-IMTP group (P = 0.034, P = 0.009, P = 0.001 and P = 0.017). FMD of NO-ASF: IMTP group was decreased significantly respectively in four times, compared with the NO-ASF:NO-IMTP group (P = 0.006, P = 0.005, P = 0.000 and P = 0.000). Pulse pressure (PP) was not different on Day 1 (P = 0.26), and was different between the two groups in the remaining three periods (P = 0.035, P = 0.040 and P = 0.014); SBP was not different between the basic value (P> 0.05), there were differences in the other three times (P < 0.05). Wlule Nitroglycerin-induced dilation (NTG) was stable throughout. Conclusions Arterial endothelial function was correlative withatherosclerosis risk factors, and that EDD and IMT as atherosclerosis alternative indicators forecast cardiovascular and cerebrovascular events after surgery is feasible.