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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Coronary artery bypass surgery and longitudinal evaluation of the autonomic cardiovascular function
Pedro Paulo S Soares1, Adalgiza M Moreno, Sérgio L D Cravo
1Department of Physiology and Pharmacology, Universidade Federal Fluminense, Niterói, RJ, Brazil. pedro.soares@incor.usp.br
Insights
Coronary artery bypass grafting (CABG) temporarily impairs cardiovascular autonomic function, with significant decreases observed around six days post-surgery. Recovery of heart rate variability and autonomic responses is evident by 60 days after CABG.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Surgical Outcomes
Background:
- Autonomic dysfunction is a risk factor for sudden death in coronary artery disease (CAD) patients.
- The impact of coronary artery bypass grafting (CABG) on autonomic function over time is not well understood.
Purpose of the Study:
- To investigate the effects of CABG on cardiovascular autonomic function.
- To determine the time course of changes in autonomic function following CABG.
Main Methods:
- Prospective longitudinal study comparing CABG patients (n=13) to CAD patients refusing surgery (n=9) and healthy controls (n=9).
- Autonomic evaluation included heart rate variability (HRV), respiratory sinus arrhythmia (RSA), and Valsalva maneuver.
- Assessments were conducted pre-surgery and at 3, 6, 15, 30, 60, and 90 days post-surgery.
Main Results:
- CABG led to a significant decrease in HRV (time and frequency domains), RSA, and Valsalva maneuver performance.
- These autonomic function measures showed a subsequent recovery trend over the study period.
Conclusions:
- CABG temporarily impairs cardiovascular autonomic function.
- Autonomic function impairment is reversible, with significant recovery observed by 60 days post-CABG.
- Maximal impairment occurred approximately six days after surgery.
Introduction:
Imbalance in autonomic cardiovascular function increases the risk for sudden death in patients with coronary artery disease (CAD), but the time course of the impact of coronary artery bypass grafting (CABG) on autonomic function has been little studied. Thus, the purpose of the present study was to determine the effects of the CABG on the cardiovascular autonomic function.
Methods:
Patients undergoing CABG (n = 13) and two matched control groups (patients with CAD who refused surgical treatment [n = 9], and healthy volunteers [n = 9]) underwent a prospective longitudinal study consisting of autonomic evaluation before and after (3, 6, 15, 30, 60, and 90 days) surgery, including measurement of heart rate variability (HRV), respiratory sinus arrhythmia (RSA), and Valsalva maneuver.
Results:
After CABG there was a decrease in, and a later recovery of, (1) the HRV in the time domain and in the frequency domain, (2) RSA, and (3) Valsalva maneuver.
Conclusions:
CABG caused an impairment, reversible after 60 days, of cardiovascular autonomic function, with a maximal decrease on about the sixth day after surgery.
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