title: Quantification of cardiac stress during EGD without sedation.
abstract: BACKGROUND
  Although the complication rate of endoscopy is low, EGD may induce cardiac stress. The aim of this study was to quantify cardiac stress during EGD.
  
  
  METHODS
  Heart rate, blood pressure, cardiac output, and peripheral oxygen saturation were measured during endoscopy without sedation in 7 volunteers. Cardiac output was measured with an automated echocardiographic technique. Cardiac index, left ventricular work index, and rate-pressure product were calculated. Serum catecholamine concentrations were measured before and after the examination.
  
  
  RESULTS
  Heart rate increased significantly when the endoscope was located in the esophagus compared with the rate before insertion (p < 0.05). No significant changes in cardiac index and left ventricular work index were observed during endoscopy. Rate-pressure product increased significantly at the point of esophageal observation compared with that before insertion (p < 0.05). The rate-pressure product was maximally increased during esophageal observation at 66% over baseline (95% CI [45%, 86%]). Serum concentration of norepinephrine rose significantly after the examination (p < 0.05).
  
  
  CONCLUSIONS
  Cardiac output did not increase during EGD without sedation in healthy male volunteers. Cardiac stress increased during EGD as indicated by a 66% increase in rate-pressure product. The cardiac stress was approximately equal to that observed in 3.3 to 5 metabolic equivalents of treadmill exercises.
authors.affiliation: Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Adachi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Yazawa
authors.forename: Mafumi
authors.initials: M
authors.lastname: Owa
authors.forename: Naohiko
authors.initials: N
authors.lastname: Koide
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Shoji
authors.initials: S
authors.lastname: Kajikawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Jun
authors.initials: J
authors.lastname: Amano
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D002395:Catecholamines / Q000097:blood; D004452:Echocardiography; D004562:Electrocardiography; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood; D013312:Stress, Physiological / Q000209:etiology / Q000503:physiopathology*; D016276:Ventricular Function
chemical_list: D002395:Catecholamines; D010100:Oxygen