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Total Knee Replacement Surgery is Followed by Transitory Endothelial Dysfunction

Krešimir Bukal
Alen Ružić
Ksenija Baždarić
Jadranko Sokolić
Andrea Vukić-Dugac
Sandra Velčić-Brumnjak
Branko Šestan
Jagoda Ravlić Gulan
Gordan Gulan

Puni tekst: engleski pdf 130 Kb

str. 611-616

preuzimanja: 343



Acute coronary syndrome (ACS) presents today the leading group of post-operative cardiovascular complications,
while endothelial dysfunction (ED) is one of the key elements in its development. The chronic ED represents thus the basis
for the gradual development of atherosclerotic changes, while its sudden aggravation leads to ACS. The persistent
ED occurs due to the effects of chronic cardiovascular risk factors, while according to the available studies it can also develop
or aggravate under the impact of different acute events. We have directed this study to the investigation of the dynamic
of endothelial function before and after a major orthopaedic surgical intervention. This randomised prospective
study included 19 patients that underwent the intervention of total knee replacement and 20 healthy examinees of the adequate
age and gender. High-resolution ultrasound test based on the flow mediated dilatation of the brachial artery is
what at we carried out at the beginning of the research, respectively 12, 24 48 and 72 hours, as well as 7 days after the
surgical intervention. The starting values of the FMD test were within the normal range in both groups, although the
ability of dilatation upon stimulus was significantly lower in the investigated group. The FMD percentage change in the
total sample was negatively connected with the body weight, not having shown additional connections with other cardiovascular
risk factors. During the early post-operative period, a significant transitory lowering of the FMD percentage
change was recorded, having reached the lowest value 24 hours after the surgery. During the seven-day prospective surveillance,
no significant cardiovascular complications were recorded. Further research is necessary in order to confirm
these results as well as the testing of the possible connection of the described post-operative transitory endothelial dysfunction
with the development of cardiovascular complications and the adverse event.

Ključne riječi

endothelial dysfunction; flow mediated dilatation; acute coronary syndrome; total knee replacement; postoperative complications

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