Endothelial Dysfunction in Perioperative Period
Condition: Endothelial Dysfunction; Postoperative Complications
MeSH terms: Postoperative Complications
Study type: Interventional

Summary: 
      Study will enroll patients scheduled for hip arthroplasty. In each subject a flow-mediated
      dilatation capability (FMD) of the brachial artery will be measured prior to elective
      surgery, within 24 hours after surgery and 5-7 days after surgery. At each session the
      brachial artery diameter will be measured at rest, during cuff inflation and 50 seconds after
      cuff deflation. From above mentioned values the increase in the diameter of the artery during
      reactive hyperemia will be calculated.

      Simultaneously with the ultrasound investigations, the blood for determination of the
      endothelial dysfunction markers will be collected.

      The participants will be contacted again 3 months after the surgery and asked about the
      complications which may be associated with the surgery.
    

Detailed description: 
      Cardiovascular complications, especially coronary heart disease, are one of the main causes
      of perioperative complications. Indicators of pre-clinical atherosclerosis, such as:
      endothelial dysfunction, increased arterial intima/media thickness (especially in the carotid
      arteries), carotid calcification and coronary calcification, suggest the presence of
      atherosclerotic process without the symptomatic presentation. Endothelial dysfunction is one
      of the earliest measurable changes that predict the development of atherosclerotic disease.

      Surgery is a significant stress for the organism: it increases the release of free oxygen
      radicals and through oxidative stress it increases systemic inflammatory response and causes
      thromboembolic complications.

      In the study 50 patients of both sexes 40-80 years of age scheduled for hip arthroplasty will
      be included. In each subject a flow-mediated dilatation capability (FMD) of the brachial
      artery will be measured prior to elective surgery, within 24 hours after surgery and 5-7 days
      after surgery. Measurement of the brachial artery flow-mediated dilatation capability (FMD):
      the brachial artery diameter will be measured 5 cm proximal to the antecubital fossa at rest,
      during cuff inflation and 50 seconds after cuff deflation. The cuff will be inflated for 4
      min. From above mentioned values the increase in the diameter of the artery during reactive
      hyperemia will be calculated.

      Simultaneously with the ultrasound investigations, the blood for determination of the
      inflammatory and endothelial dysfunction markers (CRP, IL-6, IL-8, IL-10, IL-18, TNFa, VW
      Factor, Selectin P, selectin E) will be collected.

      The participants will be contacted again 3 months after the surgery and asked about the
      complications which may be associated with the surgery.
    

Intervention name(s): EDOP
Intervention type(s): Other
Intervention description(s): no intervention
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: endothelial dysfunction; perioperative stress; cardiovascular complications; inflammatory markers