Adrenoreactivity as a prognostic criterion of perioperative cardiac complications during extracardiac operations

Abstract

Aim. To study the adrenoreactivity of the organism and the possibility of using the value of β-adrenoreception of the erythrocyte membrane as a criterion for prediction of cardiac complications in the perioperative period during extracardiac operations. Methods. In 67 patients with acute cholecystitis and concomitant cardiac pathology requiring surgical treatment, assessed was the risk of cardiac complications according to the T.H. Lee index, and β-adrenoreception of the erythrocyte membranes according to the method of R.I. Stryuk and I.G. Dlusskaya. Three groups of patients were identified: with low, medium and high risk of cardiac complications. One month after the surgery the endpoints were studied: cardiac death, nonfatal myocardial infarction, stroke, disturbances of cardiac rhythm and conduction. Results. Perioperative complications, which presented in the form of paroxysmal atrial fibrillation and atrial flutter occurred in 8% of the patients of the medium risk group, and in the form of unstable angina in 12.5% of high risk patient group. Revealed were significant differences between the parameters of β adrenoreception of the erythrocyte membranes in patients with no risk and patients from medium and high risk groups. Established was a positive correlation between the value of β-adrenoreception of the erythrocyte membranes and the risk of perioperative cardiovascular complications. Conclusion. Revealed was a decrease of β-adrenoreactivity in patients with indications for surgery for acute cholecystitis with comorbid cardiovascular disease, which reflects the process of desensitization of adrenergic receptors of the cell membranes in the activity of neurohormones.