Document Detail

A novel technique for the assessment of preoperative cardiovascular risk: reactive hyperemic response to short-term exercise.
MedLine Citation:
PMID:  23691513     Owner:  NLM     Status:  In-Data-Review    
Background. Perioperative vascular function has been widely studied using noninvasive techniques that measure reactive hyperemia as a surrogate marker of vascular function. However, studies are limited to a static setting with patients tested at rest. We hypothesized that exercise would increase reactive hyperemia as measured by digital thermal monitoring (DTM) in association to patients' cardiometabolic risk. Methods. Thirty patients (58 ± 9 years) scheduled for noncardiac surgery were studied prospectively. Preoperatively, temperature rebound (TR) following upper arm cuff occlusion was measured before and 10 minutes after exercise. Data are presented as means ± SD. Statistical analysis utilized ANOVA and Fisher's exact test, with P values <0.05 regarded as significant. Results. Following exercise, TR-derived parameters increased significantly (absolute: 0.53 ± 0.95 versus 0.04 ± 0.42°C, P=0.04, and % change: 1.78 ± 3.29 versus 0.14 ± 1.27 %, P=0.03). All patients with preoperative cardiac risk factors had a change in TR (after/before exercise, ΔTR) with values falling in the lower two tertiles of the study population (ΔTR <1.1%). Conclusion. Exercise increased the reactive hyperemic response to ischemia. This dynamic response was blunted in patients with cardiac risk factors. The usability of this short-term effect for the preoperative assessment of endothelial function warrants further study.
Robert Schier; Jochen Hinkelbein; Hanke Marcus; Ashley Smallwood; Arlene M Correa; Reza Mehran; Randa El-Zein; Bernhard Riedel
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Publication Detail:
Type:  Journal Article     Date:  2013-04-10
Journal Detail:
Title:  BioMed research international     Volume:  2013     ISSN:  2314-6141     ISO Abbreviation:  Biomed Res Int     Publication Date:  2013  
Date Detail:
Created Date:  2013-05-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101600173     Medline TA:  Biomed Res Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  837130     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany.
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