The Effects of Upper Gastrointestinal Endoscopy on the Circulatory System of Elderly Patients as Evaluated by Measuring hANP and hBNP

Abstract

Endoscopic examinations of the elderly have been increasing annually due to increase in the size of the elderly population, and due to the development and increased use of upper gastrointestinal endoscopy. The reserve potential of the circulatory system is frequently diminished in the elderly. Thus, a minimal load on the circulatory system can induce a critical status. Therefore, the effects of endoscopic examination on the circulation, most notably on the heart itself, was examined in the elderly (over 60 years old) and in younger (under 30 years old) individuals. Atrial and ventricular load were evaluated by measuring the concentration of human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP), both before and after endoscopic examination. These peptides are secreted by myocardial cells in reaction to sharp increases in cardiac load. No significant difference was observed between the blood pressure of the elderly group (21 cases) and that of the young group (10 cases), either before or after endoscopic examination. However, the pulse rate was raised significantly after the examination in both groups. Furthermore, the hANP concentration was significantly higher after the endoscopic examination in the elderly group, although no notable difference in hBNP concentration was observed after endoscopy. In the younger group, the hANP concentration did not change significantly, but the hBNP concentration was notably lower after the examination. Increased atrial load during endoscopic examination of the elderly was indicated by these observations. Therefore, overall patient status must be correctly evaluated, with particular recognition of potential circulatory system damage, when endoscopic examinations are performed on the elderly. In addition, the measurement of blood hANP and hBNP concentrations was shown to be an effective index for evaluating cardiac load during endoscopy.