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Objective <p>The significant association between anesthetic sensitivity and postoperative outcomes in patients with valvular heart disease (VD) underscores the critical need for more reliable depth-of-anesthesia monitoring. This study sought to investigate propofol sensitivity and establish specific electroencephalography (EEG) biomarkers to guide safer anesthesia delivery in this high-risk population.</p> Methods <p>In this prospective observational trial, 40 patients (20 VD vs. 20 non-cardiac controls) received Schnider model-guided propofol target-controlled infusion. Primary outcome was effect-site propofol concentration at loss of consciousness (Ce<sup>LOC</sup>). Prefrontal EEG dynamics (spectral power, bicoherence, burst suppression) were analyzed.</p> Results <p>VD patients exhibited 34% lower Ce<sup>LOC</sup> versus controls (2.8 vs. 4.25&#xa0;µg/mL; <i>p</i> = 0.0001). EEG revealed distinct neurosignatures: elevated β and θ power (β: 3.16 vs. 1.68, <i>p</i> = 0.0303; θ: 1.21 vs. 0.88, <i>p</i> = 0.0166), higher spectral power ratio (SPR: 1.38 vs. 1.98; <i>p</i> = 0.022), and intensified burst suppression (ratio: 0.11 vs. 0.32; <i>p</i> &lt; 0.0001). Bicoherence analysis demonstrated impaired cross-frequency coupling in β and δ bands (β: 40.95 vs. 34.75, <i>p</i> = 0.0253; δ:43.5 vs. 30.95, <i>p</i> &lt; 0.0001).</p> Conclusions <p>VD is associated with heightened propofol sensitivity and distinct EEG signatures, including patterns suggestive of thalamocortical dysrhythmia and cortical suppression. These findings suggest that disease-specific EEG monitoring may inform the development of precision anesthesia protocols for cardiac populations.</p>

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Heightened propofol sensitivity and distinct electroencephalographic signatures in patients with valvular heart disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月24日

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  • Yu Mao,
  • Ying Shi,
  • Liying Zhu,
  • Qingwei Wei,
  • Ziqing He,
  • Xiangjie Song,
  • Xiaodong Dai,
  • Jingjing He,
  • Lei Zhang,
  • Erwei Gu,
  • Guanghong Xu,
  • Yan Jin

摘要

Objective

The significant association between anesthetic sensitivity and postoperative outcomes in patients with valvular heart disease (VD) underscores the critical need for more reliable depth-of-anesthesia monitoring. This study sought to investigate propofol sensitivity and establish specific electroencephalography (EEG) biomarkers to guide safer anesthesia delivery in this high-risk population.

Methods

In this prospective observational trial, 40 patients (20 VD vs. 20 non-cardiac controls) received Schnider model-guided propofol target-controlled infusion. Primary outcome was effect-site propofol concentration at loss of consciousness (CeLOC). Prefrontal EEG dynamics (spectral power, bicoherence, burst suppression) were analyzed.

Results

VD patients exhibited 34% lower CeLOC versus controls (2.8 vs. 4.25 µg/mL; p = 0.0001). EEG revealed distinct neurosignatures: elevated β and θ power (β: 3.16 vs. 1.68, p = 0.0303; θ: 1.21 vs. 0.88, p = 0.0166), higher spectral power ratio (SPR: 1.38 vs. 1.98; p = 0.022), and intensified burst suppression (ratio: 0.11 vs. 0.32; p < 0.0001). Bicoherence analysis demonstrated impaired cross-frequency coupling in β and δ bands (β: 40.95 vs. 34.75, p = 0.0253; δ:43.5 vs. 30.95, p < 0.0001).

Conclusions

VD is associated with heightened propofol sensitivity and distinct EEG signatures, including patterns suggestive of thalamocortical dysrhythmia and cortical suppression. These findings suggest that disease-specific EEG monitoring may inform the development of precision anesthesia protocols for cardiac populations.