Williams Auni C, Content Virginia G, Atha Raegan E, Davé Arpit, Riley Kristin, Alexander Lacy M
Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States.
Department of Psychiatry and Behavioral Health, Penn State Health, Hershey, Pennsylvania, United States.
J Appl Physiol (1985). 2025 Aug 1;139(2):438-443. doi: 10.1152/japplphysiol.00297.2025. Epub 2025 Jul 11.
Women with endometriosis are at increased risk of cardiovascular disease and demonstrate endothelial dysfunction. The gold standard for diagnosis of endometriosis is through operative laparoscopy with surgical excision and histopathologic identification of endometrial-type glands and stroma. Symptoms of endometriosis are often immediately improved or resolved following excision surgery, but the cardiovascular impact of excision surgery is underappreciated. This passive experiment reports the longitudinal adaptations of the macrovascular and cutaneous microvascular endothelium in a single patient following surgical excision of endometriosis. The patient participated in multiple vascular research studies targeting nitric oxide-mediated vasodilation over the course of the succeeding 13 mo postsurgery. We show no nitric oxide (NO)-mediated vasodilation in the microvascular endothelium [-34 arbitrary units (AU)] and no flow-mediated dilation (FMD) in the brachial conduit artery (-0.06%) 1-mo postsurgery, with a recovery seeming to occur ∼8 mo postsurgery (178 AU, 3.69% FMD) that does not remain ∼13 mo postsurgery (3 AU, 0.43%). These values occur in tandem with reported exercise before testing [1,746 to 3,759 to 1,954 metabolic equivalent (MET) min/wk, respectively]. The results of these studies, placebo and baseline visits, are presented here. These findings suggest that microvascular endothelial function in an otherwise healthy young woman with endometriosis is not necessarily recovered following excision surgery, but may be dramatically improved with resistance exercise. Our data may lend insight into the progression of vascular dysfunction in this disease and the role of surgical versus lifestyle intervention in this realm. This passive experiment demonstrates that vascular endothelial function is not recovered following endometriosis surgery but may be improved with resistance exercise.
患有子宫内膜异位症的女性患心血管疾病的风险增加，并表现出内皮功能障碍。子宫内膜异位症诊断的金标准是通过手术腹腔镜检查，进行手术切除并对子宫内膜样腺体和间质进行组织病理学鉴定。子宫内膜异位症的症状通常在切除手术后立即得到改善或缓解，但切除手术对心血管的影响却未得到充分认识。这项被动实验报告了一名子宫内膜异位症患者在手术切除后大血管和皮肤微血管内皮的纵向适应性变化。该患者在术后13个月内参与了多项针对一氧化氮介导的血管舒张的血管研究。我们发现术后1个月时微血管内皮中无一氧化氮（NO）介导的血管舒张作用[-34任意单位（AU）]，肱动脉导管中无血流介导的舒张作用（FMD）（-0.06%），术后约8个月似乎出现恢复（178 AU，3.69% FMD）但术后13个月时未保持（3 AU，0.43%）。这些数值与测试前报告的运动情况[分别为1746至3759至1954代谢当量（MET）分钟/周]同步出现。这里展示了这些研究、安慰剂和基线访视的结果。这些发现表明，患有子宫内膜异位症的健康年轻女性在切除手术后微血管内皮功能不一定会恢复，但可能通过抗阻运动得到显著改善。我们的数据可能有助于深入了解该疾病中血管功能障碍的进展以及手术与生活方式干预在这一领域的作用。这项被动实验表明，子宫内膜异位症手术后血管内皮功能不会恢复，但可能通过抗阻运动得到改善。
