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BioMed Research International
Volume 2013 (2013), Article ID 837130, 7 pages
http://dx.doi.org/10.1155/2013/837130
Research Article

A Novel Technique for the Assessment of Preoperative Cardiovascular Risk: Reactive Hyperemic Response to Short-Term Exercise

1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
2Department of Anesthesiology and Pain Medicine, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
3Department of Thoracic Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
4Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
5Department of Anaesthesia and Pain Medicine, Peter MacCallum Cancer Centre and The University of Melbourne, Locked Bag 1, A'Beckett Street, Melbourne, VIC 8006, Australia

Received 24 September 2012; Accepted 13 March 2013

Academic Editor: Joseph Fomusi Ndisang

Copyright © 2013 Robert Schier et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Perioperative vascular function has been widely studied using noninvasive techniques that measure reactive hyperemia as a surrogate marker of vascular function. However, studies are limited to a static setting with patients tested at rest. We hypothesized that exercise would increase reactive hyperemia as measured by digital thermal monitoring (DTM) in association to patients' cardiometabolic risk. Methods. Thirty patients (58 ± 9 years) scheduled for noncardiac surgery were studied prospectively. Preoperatively, temperature rebound (TR) following upper arm cuff occlusion was measured before and 10 minutes after exercise. Data are presented as means ± SD. Statistical analysis utilized ANOVA and Fisher’s exact test, with values <0.05 regarded as significant. Results. Following exercise, TR-derived parameters increased significantly (absolute: 0.53 ± 0.95 versus 0.04 ± 0.42C, , and % change: 1.78 ± 3.29 versus 0.14 ± 1.27 %, ). All patients with preoperative cardiac risk factors had a change in TR (after/before exercise, ΔTR) with values falling in the lower two tertiles of the study population ( TR %). Conclusion. Exercise increased the reactive hyperemic response to ischemia. This dynamic response was blunted in patients with cardiac risk factors. The usability of this short-term effect for the preoperative assessment of endothelial function warrants further study.