[Endothelial dysfunction in cardiologists after 24 hours on call].
The objective was to determine if the stress caused by 24 hours on call in a cardiology emergency room alters endothelial function assessed by high-resolution ultrasonography in the brachial artery. Fifteen young physicians were studied in a crossover design: a) after a normal night of sleep at home, and b) after 24 hours on call without sleeping in an emergency room. Both studies were made at rest, 5 minutes after forearm occlusion and 3 minutes after administration of sublingual nitroglycerin. High-resolution ultrasonography and a 7.5-MHz linear array transducer were used to measure the brachial artery lumen. After 24 hours on call, physicians had significantly higher resting systolic and diastolic blood pressure. They also had a non-significant increase in heart rate and a lower brachial artery diameter. Brachial artery dilatation caused by hyperemia was only 3.35%, while it increased to 11.34% after normal sleep (p < 0.001). Only 2 physicians showed more than 4.4% dilatation, which was considered a normal response, while 13 had more than 4.4% after a normal night of sleep at home (p < 0.01). The response to nitroglycerin was similar under control conditions and after 24 hours of duty oncall.In conclusion, stress caused by 24 hours on call in a cardiology emergency room depresses or abolishes endothelial function.
García-Fernández
Raymid
R
Instituto de Cardiología y Cirugía Cardiovascular. La Habana. Cuba.
García Pérez-Velasco
Javier
J
Milián
Ariadna Concepción
AC
Peix González
Amalia
A
García-Barreto
David
D
D000328:Adult; D002309:Cardiology; D018592:Cross-Over Studies; D004636:Emergency Service, Hospital; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000503:physiopathology*; D013997:Time Factors