Peri-operative endothelial dysfunction in patients undergoing minor abdominal surgery: An observational study

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Surgical Physiology

Background:

• Myocardial injury post-noncardiac surgery is frequent, linked to adverse cardiac events.
• Acute endothelial dysfunction following surgery may drive myocardial injury pathophysiology.
• The precise link between surgical stress and endothelial function requires further elucidation.

Purpose of the Study:

• To evaluate acute peri-operative changes in endothelial function after minor elective abdominal surgery.
• To investigate the impact of minor surgery on systemic endothelial health.
• To understand early post-operative vascular changes.

Main Methods:

• Prospective, observational, single-centre study involving 60 patients.
• Non-invasive digital pulse tonometry assessed endothelial function via reactive hyperaemia index (RHI).
• Assessed RHI, nitric oxide bioavailability biomarkers, and oxidative stress markers pre- and 4-hours post-surgery.

Main Results:

• RHI significantly decreased post-surgery (1.93 to 1.76, P=0.03).
• Nitric oxide production (L-arginine/ADMA ratio) significantly reduced (213.39 to 193.3, P=0.03).
• Plasma biopterins increased, while total ascorbic acid decreased significantly (P<0.001).

Conclusions:

• Elective minor abdominal surgery acutely impairs systemic endothelial function.
• Early post-operative endothelial dysfunction is evident after non-cardiac surgery.
• Findings suggest a direct impact of surgical stress on vascular health.