Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2021; 9(6): 1318-1328
Published online Feb 26, 2021. doi: 10.12998/wjcc.v9.i6.1318
Impact of metabolism-related mutations on the heart rate of gastric cancer patients after peritoneal lavage
Yan Yuan, Shuang Yao, Guang-Hua Luo, Xiao-Ying Zhang
Yan Yuan, Department of Anesthesiology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China
Shuang Yao, Guang-Hua Luo, Comprehensive Laboratory, The Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China
Xiao-Ying Zhang, Department of Cardio-Thoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China
Author contributions: Yuan Y and Zhang XY conceived and supervised the study; Luo GH and Yao S designed the experiments; Yuan Y, Yao S and Luo GH performed the experiments; Luo GH provided new tools and reagents; Luo GH developed new software and performed simulation studies; Yuan Y and Luo GH analyzed data; Yuan Y, Yao S and Luo GH wrote the manuscript; Luo GH and Zhang XY revised the manuscript; all authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: The study was approved by the ethics committee of the Third Affiliated Hospital of Soochow University.
Informed consent statement: All participants signed an informed consent form.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ying Zhang, Chief Cardiac Surgeon, Professor, Surgeon, Department of Cardio-Thoracic Surgery, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Street, Tianning District, Changzhou 213003, Jiangsu Province, China. zhangxy6689996@163.com
Received: September 14, 2020
Peer-review started: September 14, 2020
First decision: November 23, 2020
Revised: December 4, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: February 26, 2021
Abstract
BACKGROUND

During surgery for gastric cancer, peritoneal lavage using warm distilled water can cause temporary hemodynamic changes.

AIM

To examine the associations between changes in heart rate and single nucleotide polymorphisms (SNPs).

METHODS

This was a prospective observational study of patients with gastric cancer who underwent gastrectomy and peritoneal hypotonic lavage at the Third Affiliated Hospital of Soochow University from March 2018 to March 2019. Related SNPs were selected, and the verified exons were analyzed. Heart rate and blood pressure (BP) were measured before and after lavage. The patients were grouped as heart rate change ≥ 30% vs < 30%. Comparison and regression analyses of the selected SNPs were performed between the two groups.

RESULTS

According to the inclusion/exclusion criteria, 194 patients were included in the analysis. Of these patients, 138 were male, with a mean age of 65.9 ± 0.8 years, and 56 were female, with a mean age of 65.0 ± 1.3 years. Heart rate dropped by 0%-10% in 65 participants, by 10%-15% in 29, by 15%-20% in 23, by 20%-50% in 39, by 50%-100% in four, six had a cardiac arrest, and 28 had an increase in heart rate. Considering the possible impact of exonic SNPs on the phenotypes, TEP1 (rs938886), TEP1 (rs1713449), and RECQL5 (rs820196) were analyzed. The haplotype analysis suggested that the haplotypes CTT [odds ratio (OR) = 2.018, 95% confidence interval (CI): 1.012-4.025, P = 0.0430] and GCC (OR = 2.293, 95%CI: 1.174-4.477, P = 0.0131) of TEP1 (rs938886), TEP1 (rs1713449), and RECQL5 (rs820196) increased the risk of a drop in heart rate > 30%.

CONCLUSION

The TEP1 (rs938886), TEP1 (rs1713449), and RECQL5 (rs820196) SNPs were associated with changes in heart rate ≥ 30% during intraperitoneal lavage using distilled water after gastrectomy for gastric cancer.

Keywords: Gastric cancer, Peritoneal lavage, Distilled water, Heart rate, Single-nucleotide polymorphism, Blood pressure

Core Tip: Haplotype analysis suggested that the haplotypes CTT and GCC of TEP1, TEP1, and RECQL5 increased the risk of a drop in heart rate > 30%. The TEP1 (rs938886), TEP1 (rs1713449), and RECQL5 (rs820196) single nucleotide polymorphisms were associated with changes in heart rate ≥ 30% during intraperitoneal lavage using distilled water after gastrectomy for gastric cancer.