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XXVIII Пленум Правления Белорусской ассоциации хирургов
«Актуальные вопросы и современные подходы в оказании
хирургической помощи в Республике Беларусь»
18-19 ноября 2021 года в г. Минск.
Year 2018 Vol. 26 No 1
GENERAL & SPECIAL SURGERY
V.A. SHVARTZ 1, A.R. KISELEV 1,2, A.S. KARAVAEV 3, K.A. VULF 1, E.I. BOROVKOVA 4, A.D. PETROSYAN 1, O.L. BOCKERIA 1
MUTUAL DYNAMICS OF SYNCHRONIZATION OF LOW-FREQUENCY OSCILLATIONS IN CIRCULATION VEGETATIVE REGULATION AND INDICATORS OF VARIABILITY OF THE HEART RHYTHM IN PATIENTS AFTER OPERATIONS WITH ARTIFICIAL CIRCULATION IN THE EARLY POSTOPERATIVE PERIOD
A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery 1,
Saratov State Medical University named after V.I. Razumovsky 2,
Saratov Branch of the Institute of Radio Engineering and Electronics named after V.A. Kotelnikov of RAS 3,
Saratov National Research State University named after N.G. Chernyshevsky 4 , Saratov,
The Russian Federation
Objective. To investigate peculiarity of co-operative dynamics of autonomic circulatory control indices, including synchronization of low frequency oscillations in heart rate variability (HRV) and photoplethysmogram (PPG), in patients after surgery with cardiopulmonary bypass (CPB) in the early postoperative period.
Methods. 62 patients, who had survived surgery with CPB, were included in the study (40 men, 22 women, aged 57,9±7,6 years). The synchronous registration of cardiointervalogram and PPG during 15 minutes was performed in all patients before surgery and 5-7 days after surgery in the morning. We calculated the total percentage of phase synchronization of low frequency rhythms in HRV and PPG (index S), heart rate (HR) and some assessments of HRV (SDNN, TP, HF% и LF%). We calculated the dynamics of these indices after surgery: ΔS, ΔHR, ΔSDNN, ΔHF%, ΔLF%.
Results. After surgery, index S decreased (ΔS<-5%) in 26 patients, has not changed (ΔS -5% to +5%) in 18 patients and increased (ΔS>+5%) in 18 patients. Patients with ΔS<-5% had the highest value of the index S and the lowest of TR, relatively to other patients (р<0.05). In all study phases, the strong correlation was shown for SDNN and TP (R=0.86 and 0.90, р<0.05), and the medium correlation was shown for index S и TP (R=-0.41 and -0.53, р<0.05). The multiple regression correlation was identified between ΔS and following indices: S, HF%, blood glucose, cardioplegia, ΔTP, ΔHF%.
Conclusions. We revealed the heterogeneity of patients with coronary artery disease, requiring surgery with CPB, using source autonomic status and its dynamics in the early postoperative period. We showed multiple dependent postoperative dynamics of the index S with some indices, which characterize the initial status of the patient, peculiarities of the operation and dynamics of autonomic status in the early postoperative period.
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121552, The Russian Federation,
Moscow, Rublevskoe Highway, 135,
A.N. Bakulev Scientific and Practical
Center for Cardiovascular Surgery,
Department of Surgical Treatment
of Interactive Pathology,
Tel. mobile: +79032619292,
Shvartz Vladimir A.
Shvartz Vladimir A., PhD, Researcher, Department of Surgical Treatment of Interactive Pathology, A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery, Moscow, Russian Federation.
Kiselev Anton R., MD, Researcher, Department of Surgical Treatment of Interactive Pathology, A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery, Moscow, Leading Researcher, Institute of Cardiology, Department of Promotion of New Cardiological Information Technologies, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russian Federation.
Karavaev Anatoly S., PhD, Senior Researcher, Saratov Branch of the Institute of Radio Engineering and Electronics named after V.A. Kotelnikov of RAS, Saratov, Russian Federation.
Vulf Kristina A., Post-Graduate Student, Department of Surgical Treatment of Interactive Pathology, A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery, Moscow, Russian Federation.
Borovkova Ekaterina I., Post-Graduate Student, Assistant of the Department of Dynamic Modeling and Biomedical Engineering, Saratov National Research State University named after N.G. Chernyshevsky , Saratov, Russian Federation.
Petrosyan Andrey D., Cardiovascular Surgeon, Department of Surgical Treatment of Interactive Pathology, A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery, Moscow, Russian Federation.
Bockeria Olga L., Corresponding Member of the Russian Academy of Sciences, Chief Researcher, Department of Surgical Treatment of Interactive Pathology, A.N. Bakulev Scientific and Practical Center for Cardiovascular Surgery, Moscow, Russian Federation.