Regression of endothelial dysfunction in patients with endometriosis after surgical treatment: a 2-year follow-up study.
OBJECTIVE
How does endothelial function change in women with endometriosis after surgical treatment?


CONCLUSIONS
Surgical treatment of endometriosis leads to endothelial function improvement, resulting in reduction of cardiovascular risk.


BACKGROUND
Some recent studies have demonstrated that in young women with endometriosis, even if structural alterations are absent, endothelial dysfunction, expressed as flow-mediated dilation (FMD) impairment, can nevertheless occur. However, there are no data about changes of endothelial function in women with endometriosis after surgical treatment of endometriosis.


METHODS
This is a follow-up study carried out in 68 women enrolled in a previous study. Endothelial function was evaluated 2 years after surgical procedure and compared with baseline values.


METHODS
Twenty-two patients who had undergone surgical treatment of endometriosis (named as patients with STE) and 10 control subjects without endometriosis, from the original study sample participated in this follow-up study. Assessment of endothelial function by FMD evaluation and measurements of serum markers of endothelial activation and inflammation were done in all these subjects.


RESULTS
After a 2-year follow-up period, FMD increased significantly with respect to baseline values among patients with STE [average pre- to post-difference: 5.07%, 95% confidence intervals (CI) 3.50, 6.63%; P < 0.001] but not among controls (average pre- to post-difference: 1.56%, 95% CI -0.55, 3.67%; P = 0.13). Follow-up FMD values were not significantly different between patients with STE and controls (average difference 1.50%, 95% CI -1.24, 4.23%; P = 0.27). Follow-up markers of inflammation and endothelial cells activation were similar among patients with STE and controls.


CONCLUSIONS
Although this study represents the first in the literature assessing endothelial function after surgical treatment of endometriosis, further longitudinal studies are desirable to define better the real risk that women with a history of endometriosis will develop cardiovascular events.


CONCLUSIONS
Endothelial dysfunction may be a better predictor of future cardiovascular events than traditional risk factors and the improvement in endothelial function we observed in patients after STE may have significant implications for their future cardiovascular risk.


BACKGROUND
No external funding has been either sought or obtained for this study. There are no conflicts of interest to declare.
Department of Internal Medicine, Complesso Integrato Columbus - Catholic University of Rome, Via Moscati, 31-00168 Rome, Italy.
Luca
L
Santoro
Ferruccio
F
D'Onofrio
Sebastiano
S
Campo
Pietro Manuel
PM
Ferraro
Andrea
A
Flex
Flavia
F
Angelini
Franca
F
Forni
Erica
E
Nicolardi
Vincenzo
V
Campo
Floriana
F
Mascilini
Raffaele
R
Landolfi
Paolo
P
Tondi
Angelo
A
Santoliquido
D000328:Adult; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012039:Regional Blood Flow / Q000502:physiology*; D014463:Ultrasonography
atherosclerosis; endometriosis; endothelial dysfunction; laparoscopy; surgical treatment