Relationship between perioperative cardiovascular events and serum TRPV1, CGRP and SP concentrations in patients with diabetic peripheral neuropathy / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the relationship between perioperative cardiovascular events and serum transient receptor potential vanilloid 1 (TRPV1), calcitonin gene-related peptide (CGRP) and substance P (SP) concentrations in the patients with diabetic peripheral neuropathy (DPN).Methods:Twenty-eight patients with type 2 diabetes mellitus (DM) complicated by DPN undergoing elective non-cardiovascular surgery under general anesthesia, were enrolled in DPN group, and 28 patients with type 2 DM without DPN were included in DM group.Another 28 nondiabetic patients undergoing non-cardiovascular elective surgery under general anesthesia were selected as control group (C group). The patients were 55 to 81 years old and classified as American Society of Anesthesiologists physical status Ⅱ or Ⅲ, regardless of gender.The development of cardiovascular events during surgery and within 24 h after surgery and use of vasoactive drugs were recorded.Venous blood samples were taken at 30 min before anesthesia induction and 24 h after surgery for determination of the concentrations of TRPV1, CGRP, SP and cardiac troponin I (cTnI) in serum using enzyme-linked immunosorbent assay.Results:Compared with group C, the incidence of perioperative cardiovascular events and utilization rate of vasoactive drugs were significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, and the postoperative concentration of serum cTnI was increased in DM and DPN groups ( P<0.05). Compared with DM group, the incidence of perioperative cardiovascular events was significantly increased, the preoperative concentrations of serum TRPV1, CGRP and SP were decreased, the postoperative concentration of serum cTnI was increased ( P<0.05), and no significant change was found in the utilization rate of vasoactive drugs in DPN group ( P>0.05). The postoperative cTnI concentrations in serum were negatively correlated with the preoperative TRPV1, CGRP and SP concentrations in serum in DPN group ( P<0.01). Conclusion:The increased risk of perioperative cardiovascular events may be related to the decrease in serum TRPV1, CGRP and SP concentrations in DPN patients.