Quantification of cardiac stress during EGD without sedation.
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.
Adachi
Wataru
W
Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
Yazawa
Kazuyuki
K
Owa
Mafumi
M
Koide
Naohiko
N
Hanazaki
Kazuhiro
K
Kajikawa
Shoji
S
Kobayashi
Shinya
S
Amano
Jun
J
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
D002395:Catecholamines; D010100:Oxygen