Related Experiment Video
Updated: May 2, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Does mild renal failure affect coronary flow reserve after coronary artery bypass graft surgery?
Murat Günday1, Özgür Çiftçi2, Mustafa Çalışkan2
1Faculty of Medicine, Department of Cardiovascular Surgery, Baskent University, Ankara, Turkey.
Insights
Mild renal failure in patients undergoing coronary artery bypass grafting (CABG) is linked to reduced coronary flow reserve (CFR), indicating potential microvascular damage. This finding highlights the importance of considering kidney function in cardiovascular disease management.
Area of Science:
- Cardiology
- Nephrology
- Vascular Biology
Background:
- Limited research exists on the association between mild renal failure and coronary artery disease (CAD).
- Mild renal failure may impact the distal vascular bed, affecting coronary circulation.
- Coronary artery bypass grafting (CABG) is a common procedure for CAD, but its outcomes may be influenced by renal function.
Purpose of the Study:
- To investigate the effects of mild renal failure on the distal vascular bed in patients undergoing CABG.
- To measure coronary flow reserve (CFR) using transthoracic echocardiography in patients with varying degrees of renal function.
- To assess the relationship between preoperative renal function and postoperative CFR after CABG.
Main Methods:
- A cohort of 52 patients who underwent uncomplicated CABG was studied.
- Patients were categorized into two groups based on preoperative glomerular filtration rate (GFR): mild renal failure (GFR 60-90) and normal renal function (GFR >90).
- Coronary flow reserve (CFR) was measured using second harmonic transthoracic Doppler echocardiography before and after CABG.
Main Results:
- Patients with mild renal failure (Group 1) had a significantly lower preoperative CFR (1.79 ± 0.06) compared to those with normal renal function (Group 2, 2.05 ± 0.09).
- Postoperative CFR also showed a significant difference between groups, with Group 1 having lower CFR (2.09 ± 0.08) than Group 2 (2.37 ± 0.06).
- A significant increase in CFR was observed post-CABG across both groups, but the preoperative deficit in the mild renal failure group persisted.
Conclusions:
- Mild renal failure is associated with a decreased coronary flow reserve in patients undergoing CABG.
- Deterioration of the microvascular bed in patients with mild renal failure may contribute to adverse effects following CABG.
- These findings suggest that renal function should be carefully considered in the management of patients with coronary artery disease.
Introduction:
There are only a limited number of studies on the link between mild renal failure and coronary artery disease. The purpose of this study is to investigate the effects of mild renal failure on the distal vascular bed by measuring the coronary flow reserve (CFR) in transthoracic echocardiography after coronary artery bypass grafting (CABG).
Methods:
The study included 52 consecutive patients (12 women and 40 men) who had undergone uncomplicated CABG. The patients were divided into 2 groups. Group 1 included patients with a preoperative glomerular filtration rate (GFR) of 60-90 (mild renal failure), and group 2 included those with a GFR >90. The CFR measurements were carried out through a second harmonic transthoracic Doppler echocardiography.
Results:
The mean age was 60.08 ± 1.56 years in group 1 and 60.33 ± 1.19 in group 2. The mean preoperative CFR was 1.79 ± 0.06 in group 1 and 2.05 ± 0.09 in group 2. The mean postoperative CFR was 2.09 ± 0.08 in group 1 and 2.37 ± 0.06 in group 2. There was a statistically significant difference between the 2 groups as to preoperative creatinine clearance, preoperative estimated GFR, postoperative day 7 creatinine clearance, postoperative month 6 creatinine clearance, postoperative day 7 estimated GFR, postoperative month 6 estimated GFR, preoperative CFR, and postoperative CFR (P < .05). CFR was found to be unaffected by the choice of on-pump or off-pump technique (P = .907). After bypass surgery, there was a significant increase in the mean postoperative CFR, when compared with the mean preoperative CFR (P = .001).
Conclusion:
In our study, we detected a decrease in CFR in patients with mild renal failure. We believe that in patients undergoing CABG for coronary artery disease, mild renal failure can produce adverse effects due to deterioration of the microvascular bed.
More Related Videos
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:22Heart Failure Drugs: Diuretics
01:30Heart Failure V: Medical Management
01:27Coronary Artery Disease V: Interprofessional Care
01:29Heart Failure II: Pathophysiology
01:22Heart Failure VI: Adjunct Therapies