Effect of coronary artery bypass grafting on blood pressure response to head-up tilting

Hori, Shinnosuke; Kamijo, Yoshi‐ichiro; Yuzaki, Mitsuru; Kawabe, Takao; Minami, Kazunobu; Umemoto, Yasunori; Yokoyama, Michiaki; Uenishi, Hiroyasu; Nishimura, Yoshiharu; Kouda, Ken; Mikami, Yukio; Tajima, Fumihiro

doi:10.1186/s12576-020-00746-1

Cited by 2 publications

(5 citation statements)

References 43 publications

(65 reference statements)

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“…However, the compensation could hardly cover the preliminary pathophysiological changes. The initial decrease of SV is also reported in other patients with obstructive and cariogenic hypotension (Hurewitz et al, 1986;Kearns and Walley, 2018;Hori et al, 2020). According to Figure 1, the decrease of SV is sensitively reflected in the change of SBP.…”

Section: The Decrease Of Sv Reflects the Early Hemodynamic Changes Especially When Co Remains Unchanged Sbp Can Reflect Early Hemodynamicsupporting

confidence: 69%

SBP Is Superior to MAP to Reflect Tissue Perfusion and Hemodynamic Abnormality Perioperatively

Sun

Yuan

2021

Front. Physiol.

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Many articles have reported that intraoperative low mean artery pressure (MAP) or low systolic blood pressure (SBP) impacts on organs’ function and patients’ outcomes perioperatively. On the contrary, what type of blood pressure should be obtained still needs to be clarified. In our paper, we compared the influencing factors of MAP and SBP, and mathematical formula, arterial pulse contour calculation, and cardiovascular physiological knowledge were adopted to discuss how blood pressure can effectively reflect tissue perfusion and hemodynamic abnormality perioperatively. We concluded that MAP can reflect cardiac output change sensitively and SBP can reflect stroke volume change sensitively. Moreover, SBP can reflect the early hemodynamic changes, organs’ perfusion, and heart systolic function. Compared with MAP, perioperative monitoring of SBP and timely detection and treatment of abnormal SBP are very important for the early detection of hemodynamic abnormalities.

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Section: The Decrease Of Sv Reflects the Early Hemodynamic Changes Especially When Co Remains Unchanged Sbp Can Reflect Early Hemodynamicsupporting

confidence: 69%

SBP Is Superior to MAP to Reflect Tissue Perfusion and Hemodynamic Abnormality Perioperatively

Sun

Yuan

2021

Front. Physiol.

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“…We have already reported that a decrease in blood pressure during HUT was due to a decrease in CO, i.e. reduced SV, in CAD patients just after the surgery, because a decrease in SV and the decreased blood pressure was exacerbated even HR response was improved in nine patients [3]. In the present study, we followed-up cardiovascular responses during the HUT test in the patients 1.3-1.8 years after undergoing CABG.…”

Section: Discussionmentioning

confidence: 69%

“…We excluded the participants with emergent surgery, who were not able to walk independently; were on dialysis; had a history of stroke, cardiovascular disease, chronic obstructive pulmonary disease, and/or severe cardiac arrhythmia; and were reported as bed rest before surgery. Nine patients were assessed before and after surgery in our previous study [Hori et al 2020]. Six patients completed measurements over one year after surgery.…”

Section: Participantsmentioning

confidence: 99%

“…Rehabilitation treatment was started on the rst day after CABG, depending on the patient's condition. Details menus have been reported previously by Hori et al [3]. Brie y, patients were mobilized out of bed on the rst day after surgery and underwent training for approximately 60 minutes every day, except for Sunday.…”

Section: Experimental Designmentioning

confidence: 99%

“…Early mobilization for patients after cardiac surgery, such as coronary artery bypass grafting (CABG), is bene cial owing to the prevention of postoperative complications, improvement of functional ability, and shortening of hospital stay [1,2]. However, Hori et al reported that the blood pressure during head-up tilt (HUT) decreases before CABG and this decrease worsens with the reduction in body weight at the time of discharge after surgery (around the 14th hospital day), even rehabilitation therapy was performed [3]. Diuretics as well as b-blockers are administered after CABG surgery to prevent postoperative atrial brillation and cardioplegia [4,5].…”

Section: Introductionmentioning

confidence: 99%

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A prospective and preliminary observation of cardiovascular responses to the head-up tilting test in patients with over 1-year follow-up after coronary artery bypass grafting

Hori

Nishimura

Kamijo

et al. 2023

Preprint

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Hori et al. have suggested previously that blood pressure during a head-up tilt (HUT) in a patient after CABG at discharge was likely to decrease, even they took exercise therapy. Medication status after CABG and reduced stroke volume, one of index for blood volume, would be related with it. On the other hand, some natural adaptations to orthostatic stress in the patients may be expected over long-term recovery. However, there was no study to assess blood pressure during HUT after CABG while monitoring medication status and stroke volume over a long period. Changes in cardiovascular responses to HUT in 6 patients were preliminarily tested during supine and 15-min 60°HUT before (P0) and after coronary artery bypass grafting (CABG) (P1) and over 1-year after surgery (P2). Mean arterial pressure (MAP) decreased during HUT at P0 and P1 and the decrease at P1 was greater than P0, while it remained unchanged at P2. Heart rate (HR) increased during HUT at P0 and P1 and the increase at P1 tended to be greater than P0, while that at P2 were comparable to P0. Stroke volume (SV) was 30% lower during baseline at P1 and P2 than P0. Cardiac output reduced by HUT at P0, but was not affected at P1 and P2, while the baseline at P2 was lower than P0. Ejection fraction remained unchanged at 3 periods. In conclusion, baseline SV at P2 remained lower than P0, but MAP was maintained during HUT. The present results suggest that although the poor control of blood pressure just after is improved over 1 year after CABG, hypovolemia might not be corrected. Assessments of an exercise regimen over long term after CABG would be expected in the future.

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Effect of coronary artery bypass grafting on blood pressure response to head-up tilting

Cited by 2 publications

References 43 publications

SBP Is Superior to MAP to Reflect Tissue Perfusion and Hemodynamic Abnormality Perioperatively

SBP Is Superior to MAP to Reflect Tissue Perfusion and Hemodynamic Abnormality Perioperatively

A prospective and preliminary observation of cardiovascular responses to the head-up tilting test in patients with over 1-year follow-up after coronary artery bypass grafting

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