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Arterial baroreflex dysfunction after coronary artery bypass grafting

Mats Johansson1, Ann-Kristin Karlsson, Anna Myredal

  • 1Department of Internal Medicine, Varberg Hospital, Varberg, Sweden. matsjohans@telia.com

Interactive Cardiovascular and Thoracic Surgery
|January 16, 2009
PubMed

Insights

Arterial baroreflex dysfunction is common after coronary artery bypass grafting (CABG), persisting long-term. This dysfunction may increase the risk of ventricular arrhythmias in CABG patients.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Post-Surgical Recovery

Background:

  • Ventricular arrhythmia and sudden cardiac death are significant risks in specific patient groups following coronary artery bypass grafting (CABG).
  • Arterial baroreflex dysfunction is a known risk factor for ventricular arrhythmias and sudden cardiac death.

Purpose of the Study:

  • To investigate arterial baroreflex function in patients during the early recovery period and up to five months after undergoing CABG.
  • To compare arterial baroreflex function between post-CABG patients and healthy subjects.

Main Methods:

  • Electrocardiogram and beat-to-beat blood pressure were recorded in 92 patients post-CABG at five weeks and five months after surgery.
  • 31 healthy subjects were included as a control group.
  • Arterial baroreflex sensitivity (ABRS) and baroreflex effectiveness index (BEI) were calculated.

Main Results:

  • Five weeks after CABG, patients showed significantly reduced ABRS (36% decrease) and BEI (64% decrease) compared to healthy subjects (P<0.01 for both).
  • While values improved at five months, the BEI remained significantly reduced by 55% in patients compared to healthy subjects (P<0.01).

Conclusions:

  • Arterial baroreflex dysfunction is a persistent issue, evident both early and long-term after CABG.
  • Impaired modulation of cardiac parasympathetic activity due to baroreflex dysfunction may contribute to the elevated risk of ventricular arrhythmias post-cardiac surgery.

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