Correlation Of Perioperative Adverse Cardiovascular Events With Reductions Of Serum TRPV1,CGRP,SP In Patients With Diabetic Peripheral Neuropathy

Objective:To investigate the relationship between perioperative adverse cardiovascular events and reductions of serum transient receptor potential vanilloid 1(TRPV1),calcitonin gene-related peptide(CGRP)and substance P(SP)in the patients with diabetic peripheral neuropathy(DPN).Methods:Fifty-six patients of either gender,ASA II-III,aged 55-81 years old with type 2diabetes mellitus(DM)undergoing elective non-cardiovascular surgery under general anesthesia were consecutively enrolled and assigned into two groups,DPN group(n=28)and DM group(n=28),according to whether the patients were complicated with peripheral neuropathy or not.Another 28 non-diabetic patients undergoing elective non-cardiovascular surgery under general anesthesia were enrolled as a control group.The differences in serum TRPV1,CGRP and SP before the surgery and cTnI at 24h after the operation were analyzed using ELISA assay.The incidence of perioperative adverse cardiovascular events(PACE)was evaluated.Results:A longer course of disease of diabetes was presented in the patients with DPN than those suffered diabetes only(P<0.05).Higher incidence of PACE and greater concentration of serum cTnI were observed in the DPN and DM groups,with the order of both parameters in the groups as Control<DM<DNP(all P<0.05).However,lower levels of TRPV1,CGRP and SP were simultaneously detected in the patients in DPN and DM groups,with the order of the parameters in the groups as Control>DM>DNP(all P<0.05).Correlation analysis indicates that the postoperative cTnI level were negatively correlated with the levels of preoperative TRPV1(r~2=0.5889,P<0.0001),CGRP(r~2=0.5545,P<0.0001)and SP(r~2=0.5542,P<0.0001)in the patients of DPN group.Conclusion:The reductions of serum TRPV1,CGRP and SP are associated with increase of PACE and myocardial injury.The lower levels of molecules in the serum is of potential applications for prediction of intraoperative risks of myocardial injury and adverse cardiovascular events in the patients with DPN.