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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
A Retrospective Study of Hemodynamic Changes in Patients After Off-Pump Coronary Artery Bypass Graft Surgery Using
Xinrong Niu1, Qingqing Zhang2, Dong Xiao2
1First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland).
Insights
Impedance cardiography (ICG) effectively evaluates hemodynamic changes after off-pump coronary artery bypass graft (OPCABG) surgery, correlating with brain natriuretic peptide (BNP) levels and echocardiography. This suggests ICG
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Hemodynamics
Background:
- Off-pump coronary artery bypass graft (OPCABG) surgery requires precise hemodynamic monitoring.
- Assessing cardiac function post-OPCABG is crucial for patient recovery.
- Non-invasive monitoring methods are valuable in post-cardiac surgery care.
Purpose of the Study:
- To investigate the utility of impedance cardiography (ICG) in evaluating hemodynamic changes in patients following OPCABG.
- To correlate ICG-derived parameters with established markers of cardiac function, such as brain natriuretic peptide (BNP) and echocardiography.
- To determine the potential role of ICG in routine clinical assessment of cardiac function post-OPCABG.
Main Methods:
- One hundred sixty patients undergoing OPCABG were enrolled.
- Impedance cardiography (ICG) was used to measure various hemodynamic parameters including stroke volume (SV), cardiac output (CO), and left ventricular ejection fraction (LVEF).
- ICG parameters were correlated with brain natriuretic peptide (BNP) levels and echocardiography findings using multivariate regression analysis.
Main Results:
- Cardiac output (CO) showed significant differences across New York Heart Association (NYHA) functional classes.
- Several ICG parameters, including SV, SI, CO, acceleration index (ACI), and left ventricular ejection time (LVET), demonstrated significant correlations with BNP levels.
- Systemic vascular resistance (SVR), pre-ejection period (PEP), and systolic time ratio (STR) were positively correlated with BNP (P<0.05).
Conclusions:
- Impedance cardiography (ICG) parameters show significant correlations with brain natriuretic peptide (BNP) levels and echocardiography results in patients after OPCABG.
- ICG demonstrates potential as a valuable tool for assessing cardiac hemodynamic changes in the clinical management of post-OPCABG patients.
- The findings support the consideration of ICG for routine cardiac function assessment in this patient population.
Abstract:
BACKGROUND This study aimed to investigate the role of impedance cardiography (ICG) to evaluate hemodynamic changes in patients after off-pump coronary artery bypass graft (OPCABG) surgery. MATERIAL AND METHODS One-hundred and sixty patients who had undergone OPCAGB were enrolled and assessed using New York Heart Association NYHA functional class (II, II, and IV). ICG was used to measure the stroke volume (SV), stroke volume index (SI), cardiac output per minute (CO/min), cardiac index (CI), end-diastolic volume (EDV), pre-ejection period (PEP), left ventricular ejection time (LVET), systolic time ratio (STR), left ventricular ejection fraction (LVEF), acceleration index (ACI), systemic vascular resistance (SVR), and thoracic fluid content (TFC). The ICG parameters were correlated with brain natriuretic peptide (BNP) and echocardiography parameters using multivariate regression analysis. RESULTS The levels of CO, ACI, TFC, SVR, and BNP compared with ICG showed differences between NYHA functional class, with CO showing a significant difference (p<0.05). There were no significant differences between SV, SI, EDV, and LVEF before and after OPCAGB. Using ICG, the parameters of CI, LVEF, EDV, and TFC showed no significant correlation with BNP. SV, SI, CO, ACI, and LVET, which were negatively correlated with BNP. SVR, PEP, and STR were positively correlated with BNP (P<0.05). CONCLUSIONS In patients who had OPCABG, the findings from ICG were significantly correlated with BNP levels and the results from echocardiography for the evaluation of cardiac hemodynamic changes. ICG might have a role in the assessment of cardiac function in clinical practice.
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