ADRB2 gly16gly Genotype, Cardiac Output, and Cerebral Oxygenation in Patients Undergoing Anesthesia for Abdominal Aortic Aneurysm Surgery
| Autor: | Niels H. Secher, Lars Lönn, Jonatan Myrup Staalsø, Teit Mantoni, Henning B. Nielsen, Ulf Johan Vilhelm Helgstrand, Niels D. Olesen, Niels Vidiendal Olsen, Kim Zillo Rokamp |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Cardiac output medicine.medical_specialty Cerebral oxygen saturation Anesthesia General Polymorphism Single Nucleotide 03 medical and health sciences Aortic aneurysm 0302 clinical medicine 030202 anesthesiology Monitoring Intraoperative Internal medicine Humans Medicine Oximetry Cardiac Output Elective surgery Aged Spectroscopy Near-Infrared business.industry Homozygote Oxygenation medicine.disease Abdominal aortic aneurysm Confidence interval Surgery Oxygen Phenotype Treatment Outcome Anesthesiology and Pain Medicine Elective Surgical Procedures Cerebrovascular Circulation Anesthesia Cardiology Female Receptors Adrenergic beta-2 business Vascular Surgical Procedures Biomarkers 030217 neurology & neurosurgery Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Anesthesia & Analgesia. 123:1408-1415 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/ane.0000000000001563 |
| Popis: | BACKGROUND Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C). Genotyping was performed with the TaqMan assay. RESULTS Before anesthesia, Q and SCO2 were 4.7 ± 1.2 L/min and 66% ± 8%, respectively, and linearly correlated (r = 0.35, P < .0001). In patients with the gly16gly genotype baseline, Q was approximately 0.4 L/min greater than in arg16 carriers (CI95: 0.0-0.8, Pt test = .03), but during anesthesia, the difference was 0.3 L/min (Pmixed-model = .07). Post hoc analysis revealed the change in SCO2 from baseline to the induction of anesthesia to be on average 2% greater in gly16gly homozygotes than in arg16 patients when adjusted for the change in Q (P = .03; CI95: 0.2-4.0%). CONCLUSIONS This study suggests that the β2-adrenoceptor gly16gly genotype is associated with the elevated resting Q. An interesting trend to greater frontal lobe oxygenation at induction of anesthesia in patients with gly16gly genotype was found, but because of insufficient sample size and lack of PCO2 control throughout the measurements, the presented data may only serve as the hypothesis generating for future studies. The confidence limits indicate that the magnitude of the effects may range from clinically insignificant to potentially important. |
| Databáze: | OpenAIRE |
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