Impaired Endothelial Function After Aneurysmal Subarachnoid Haemorrhage Correlates With Arginine

Bergström, Anita; Staalsø, Jonatan Myrup; Romner, Bertil; Olsen, N V

doi:10.1097/sa.0000000000000074

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…The endothelial function was assessed within 4-24 h after surgery and on postoperative day 3-5. Such time intervals have previously been used when assessing the endothelial function after an acute event [25]. However, the large variance could add to the heterogeneity of the study.…”

Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction and myocardial injury after major emergency abdominal surgery: a prospective cohort study

et al. 2020

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Background: Preoperative endothelial dysfunction is a predictor of myocardial injury and major adverse cardiac events. Non-cardiac surgery is known to induce acute endothelial changes. The aim of this explorative cohort study was to assess the extent of systemic endothelial dysfunction after major emergency abdominal surgery and the potential association with postoperative myocardial injury.Methods: Patients undergoing major emergency abdominal surgery were included in this prospective cohort study. The primary outcome was the change in endothelial function expressed as the reactive hyperemia index from 4-24 h after surgery until postoperative day 3-5. The reactive hyperemia index was assessed by non-invasive digital pulse tonometry. Secondary outcomes included changes in biomarkers of nitric oxide metabolism and bioavailability. All assessments were performed at the two separate time points in the postoperative period. Clinical outcomes included myocardial injury within the third postoperative day and major adverse cardiovascular events within 30 days of surgery. Results: Between October 2016 and June 2017, 83 patients were included. The first assessment of the endothelial function, 4-24 h, was performed 15.8 (SD 6.9) hours after surgery and the second assessment, postoperative day 3-5, was performed 83.7 (SD 19.8) hours after surgery. The reactive hyperemia index was suppressed early after surgery and did not increase significantly; 1.64 (95% CI 1.52-177) at 4-24 h after surgery vs. 1.75 (95% CI 1.63-1.89) at postoperative day 3-5, p = 0.34. The L-arginine/ADMA ratio, expressing the nitric oxide production, was reduced in the perioperative period and correlated significantly with the reactive hyperemia index. A total of 16 patients (19.3%) had a major adverse cardiovascular event, of which 11 patients (13.3%) had myocardial injury. The Larginine/ADMA ratio was significantly decreased at 4-24 h after surgery in patients suffering myocardial injury.Conclusion: This explorative pathophysiological study showed that acute systemic endothelial dysfunction was present early after major emergency abdominal surgery and remained unchanged until day 3-5 after the procedure. Early postoperative disturbances in the nitric oxide bioavailability might add to the pathogenesis of myocardial injury. This pathophysiological link should be confirmed in larger studies. Trial registration: clinicaltrials.gov no. NCT03010969.

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Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction and myocardial injury after major emergency abdominal surgery: a prospective cohort study

et al. 2020

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“…There was no difference in ADMA levels between nondiabetic and diabetic participants. Also, derived directly from the measurements of Arg and ADMA, Arg/ADMA ratio, which has been proposed as an indirect measure of endothelial function, 34,35 was significantly lower in participants with than in participants without T2DM: 156 ± 82 vs 181 ± 79 μmol/L, P < .05. Asymmetric dimethylarginine was positively related to age (r = 0.4; P < .0001) and to serum creatinine (r = 0.57; P < .0001).…”

Section: Serum Admamentioning

confidence: 99%

Serum asymmetric dimethylarginine and arginine levels predict microvascular and macrovascular complications in type 2 diabetes mellitus

Ganz

Wainstein

Gilad

et al. 2016

Diabetes Metabolism Res

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“…Novel methods of preoperative risk stratification include non-invasive assessment of endothelial function, which was employed by McIlroy and colleagues, 3 who suggested that this parameter could serve as a predictor of perioperative myocardial injury in patients undergoing non cardiac surgery. Bergstrom and colleagues 4 reported the use of peripheral arterial tonometry to show impaired endothelial function in patients after subarachnoid haemorrhage, and Scherbakov and Doehner 5 discuss the basis of this method as a surrogate for assessing endothelial dysfunction, and suggest that it could become a clinical diagnostic tool. Extending the use of currently used laboratory tests, Holm and colleagues 6 showed that measurement of N-terminal pro-B-type natriuretic peptide concentration improves EuroSCORE II based prediction of circulatory failure following coronary artery bypass grafting.…”

Section: Preoperative Carementioning

confidence: 99%

BJA 2014; An overview

Chana

Mahajan

2015

British Journal of Anaesthesia

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Impaired Endothelial Function After Aneurysmal Subarachnoid Haemorrhage Correlates With Arginine

Cited by 3 publications

References 5 publications

Endothelial dysfunction and myocardial injury after major emergency abdominal surgery: a prospective cohort study

Endothelial dysfunction and myocardial injury after major emergency abdominal surgery: a prospective cohort study

Serum asymmetric dimethylarginine and arginine levels predict microvascular and macrovascular complications in type 2 diabetes mellitus

BJA 2014; An overview

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