Biomedical papers - Ahead of Print

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | 10.5507/bp.2017.045

Autonomic control of blood circulation in patients undergoing elective carotid endarterectomy

Karel Vykoupila, Jan Galuszkaa, Petr Dračb, Milos Taborskya
a Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
b Department of Surgery II - Vascular and Transplantation Surgery, University Hospital Olomouc, Czech Republic

Background: Internal carotid artery stenosis (ICAS) is associated with significantly higher risk of stroke. Autonomic function can be impaired in the presence of atheroma in the carotid sinus region. Two parameters of autonomic nervous system (ANS) function e.g. heart rate variability (HRV) and baroreflex sensitivity (BRS) are respected predictors of cardiovascular prognosis. We assessed the effect of elective unilateral carotid endarterectomy (CEA) on cardiovascular autonomic functions as a major prognostic factor for cardiovascular health.

Methods: Nineteen patients indicated for CEA underwent formal autonomic assessment in the laboratory. Hemodynamic profiles, HRV and BRS were evaluated with the dedicated high-tech device Task Force Monitor before surgery (day-1) and postoperatively (day 3±1). Data were obtained during 5 min orthostatic challenge and subsequent 5 min in a supine position.

Results: There were no significant early postoperative changes in evaluated parameters after CEA. There was a mild decrease of blood pressure and therefore only a slight increase in BRS. It was also possible to observe a rise in the value of total power and high frequency power.

Conclusion: In the early postoperative period, healing processes are occurring and the sympatho-vagal interaction is probably still unbalanced. Given the considerable clinical potential of BRS and HRV measurement, further short-term and, more importantly, long-term investigations are needed.

Keywords: Key words: internal carotid artery stenosis, autonomic functions, Task Force Monitor, baroreflex sensitivity, heart rate variability

Received: May 13, 2017; Accepted: October 17, 2017; Prepublished online: October 27, 2017


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