Comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting or correction of valvular heart disease

Abstract

Introduction: Our aim was to perform a comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or surgical correction of valvular heart disease (SCVHD ). Methods: The synchronous 15 minutes records of heart rate variability (HRV) and finger’s photoplethysmographic waveform variability (PPGV) were performed in 42 cardiac surgery patients (12 women) aged 61.8 ± 8.6 years (mean ± standard deviation), who underwent CABG, and 36 patients (16 women) aged 54.2 ± 14.9 years, who underwent SCVHD , before surgery and in 5-7 days after surgery. Conventional time and frequency domain measures of HRV and index S of synchronization between the slow oscillations in PPGV and HRV were analyzed. We also calculated personal dynamics of these indices after surgery. Results: We found no differences (Р > 0.05) in all studied autonomic indices (preoperative and post-surgery) between studied patients’ groups, except for the preoperative heart rate, which was higher in patients who underwent SCVHD (P = 0.013). We have shown a pronounced preoperative and post-surgery variability (magnitude of inter-quartile ranges) of all autonomic indices in studied patients. In the cluster analysis based on cardiovascular autonomic indices (preoperative and post-surgery), we divided all patients into two clusters (38 and 40 subjects) which did not differ in all clinical characteristics (except for the preoperative hematocrit, P = 0.038), index S, and all post-surgery HRV indices. First cluster (38 patients) had higher preoperative values of the HR, TP, HF, and HF%, and lower preoperative values of the LF% and LF/HF. Conclusion: The variability of cardiovascular autonomic indices in on-pump cardiac surgery patients (two characteristic clusters were identified based on preoperative indices) was not associated with their clinical characteristics and features of surgical procedure (including cardioplegia).

Skeletal muscle status, autonomic balance and short-term results of cardiac surgery

“…However, the study of Shvartz V.A. et al [12] with assessment of the pre and postoperative cardiovascular autonomic parameters showed no differences in the groups of patients undergoing CABG and valve prosthetics. Autonomic balance indices did not depend on the type and volume of surgical intervention and clinical characteristics of the patients.…”

“…Since the muscles of the lower extremities are most important for restoring physical activity after cardiac surgery, assessment of their functional status would be rational, which created the basis for the present study. Another option in assessing the patient's preoperative status is evaluation of their autonomic balance; in particular, heart rate variability indicators have been suggested as a complications prediction tool [11][12]. A comprehensive assessment of muscle and autonomic status in patients with cardiac surgery has not been carried out yet.…”

The Effect of Short-Term Transcutaneous Electrical Stimulation of Auricular Vagus Nerve on Parameters of Heart Rate Variability

“…The parameters of HRV assessed in this study are presented in Table 1. Their physiological interpretation is not discussed in this article since it was specified in our previous publications [36][37][38][39]. In addition, the raw records of the rhythmograms of all the subjects in EDF format, as well as the dataset containing clinical, instrumental, and laboratory data of all the study subjects are available for possible secondary analysis to all interested researchers (2022 data, n = 71).…”