Hemodynamic parameters in pre- and post-intervention period among hypertensive patients undergoing laparoscopic cholecystectomy

Abstract

Aim. To compare the pre- and post-intervention hemodynamic parameters, assessed by volumetric compression oscillometry (VCO), in patients with arterial hypertension undergoing laparoscopic cholecystectomy. Material and methods. The study included 80 patients with systolo-diastolic arterial hypertension (AH), examined before and after laparoscopic cholecystectomy. Group 1 included 38 patients (31 women, 7 men; mean age 60,2±1,8 years) with controlled blood pressure (BP) (120,1±1,3/75,2±1,2 mm Hg). Group 2 comprised of 42 patients (37 women, 5 men; mean age 63,4±1,5 years) with uncontrolled BP (151,6±2,4/87,4±1,8 mm Hg). The control group included 50 healthy people (25 women, 25 men; mean age 27,8±0,8 years) with normal BP levels (118,5±1,6/71,82±1,2 mm Hg). Hemodynamic parameters were assessed using VCO. Results. Before the intervention, all hemodynamic parameters in Group 1 were within the normal physiological range; hyper- and eukinetic hemodynamic types were registered more often than combined and hypokinetic ones. In Group 2, all parameters were increased, including AH phenotypes, vascular characteristics (except peripheral vascular resistance, PVR), and cardiac parameters (except heart rate), which suggested the increased myocardial contractility due to elevated arterial wall tonus and peripheral resistance. Hyper- and eukinetic hemodynamic types were registered less often than combined and hypokinetic ones. After the intervention, both groups demonstrated a reduction in all AH phenotypes, vascular characteristics (linear blood flow velocity, pulse wave velocity, and factual-toworking PVR, with elevated working PVR), cardiac parameters (stroke volume, stroke index, minute blood volume, cardiac index, volume velocity of cardiac output, left ventricular contractility, and cardiac energy expenditure). Cardiac hemodynamic types changed from hyperkinetic, combined, and hypokinetic variants to eukinetic one. Conclusion. Irrespective of baseline levels, post-intervention BP reduction was observed in all patients. However, in patients with controlled BP, it was due to a comparable reduction in both myocardial and vascular strain, while in participants with uncontrolled BP, it was primarily due to reduced myocardial strain.

Keywords

• arterial hypertension
• peri-intervention period
• volumetric compression oscillometry