Pantoni Camila Bianca Falasco, Mendes Renata Gonçalves, Di Thommazo-Luporini Luciana, Simões Rodrigo Polaquini, Amaral-Neto Othon, Arena Ross, Guizilini Solange, Gomes Walter José, Catai Aparecida Maria, Borghi-Silva Audrey
Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of São Carlos, São Carlos, Brazil.
Clin Physiol Funct Imaging. 2014 Nov;34(6):449-56. doi: 10.1111/cpf.12115. Epub 2013 Dec 26.
Conventional coronary artery bypass grafting (C-CABG) and off-pump CABG (OPCAB) surgery may produce different patients' outcomes, including the extent of cardiac autonomic (CA) imbalance. The beneficial effects of an exercise-based inpatient programme on heart rate variability (HRV) for C-CABG patients have already been demonstrated by our group. However, there are no studies about the impact of a cardiac rehabilitation (CR) on HRV behaviour after OPCAB. The aim of this study is to compare the influence of both operative techniques on HRV pattern following CR in the postoperative (PO) period.
Cardiac autonomic function was evaluated by HRV indices pre- and post-CR in patients undergoing C-CABG (n = 15) and OPCAB (n = 13). All patients participated in a short-term (approximately 5 days) supervised CR programme of early mobilization, consisting of progressive exercises, from active-assistive movements at PO day 1 to climbing flights of stairs at PO day 5.
Both groups demonstrated a reduction in HRV following surgery. The CR programme promoted improvements in HRV indices at discharge for both groups. The OPCAB group presented with higher HRV values at discharge, compared to the C-CABG group, indicating a better recovery of CA function.
Our data suggest that patients submitted to OPCAB and an inpatient CR programme present with greater improvement in CA function compared to C-CABG.
传统冠状动脉旁路移植术(C-CABG)和非体外循环冠状动脉旁路移植术(OPCAB)可能产生不同的患者预后,包括心脏自主神经(CA)失衡的程度。我们团队已经证明了基于运动的住院计划对C-CABG患者心率变异性(HRV)的有益影响。然而,尚无关于心脏康复(CR)对OPCAB术后HRV行为影响的研究。本研究的目的是比较两种手术技术在术后(PO)期CR后对HRV模式的影响。
对接受C-CABG(n = 15)和OPCAB(n = 13)的患者在CR前后通过HRV指标评估心脏自主神经功能。所有患者均参加了为期约5天的短期监督CR计划,包括早期活动,从术后第1天的主动辅助运动到术后第5天的爬楼梯。
两组术后HRV均降低。CR计划促进了两组出院时HRV指标的改善。与C-CABG组相比,OPCAB组出院时HRV值更高,表明CA功能恢复更好。
我们的数据表明,与C-CABG相比,接受OPCAB和住院CR计划的患者CA功能改善更大。