First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (mainland).
Department of Critical Care Medicine, Peoples' Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China (mainland).
Med Sci Monit. 2019 May 10;25:3454-3462. doi: 10.12659/MSM.913289.
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.
本研究旨在探讨阻抗心动图(ICG)在评价不停跳冠状动脉旁路移植术(OPCABG)后患者血流动力学变化中的作用。
本研究纳入了 160 名接受 OPCABG 的患者,并根据纽约心脏协会心功能分级(II、III 和 IV 级)进行评估。使用 ICG 测量每搏量(SV)、每搏量指数(SI)、每分钟心输出量(CO/min)、心指数(CI)、舒张末期容积(EDV)、射前期(PEP)、左心室射血时间(LVET)、收缩时间比(STR)、左心室射血分数(LVEF)、加速度指数(ACI)、体循环血管阻力(SVR)和胸腔液含量(TFC)。使用多元回归分析将 ICG 参数与脑钠肽(BNP)和超声心动图参数相关联。
与 ICG 相比,CO、ACI、TFC、SVR 和 BNP 的水平在 NYHA 心功能分级之间存在差异,CO 具有显著差异(p<0.05)。OPCABG 前后 SV、SI、EDV 和 LVEF 无显著差异。使用 ICG,CI、LVEF、EDV 和 TFC 参数与 BNP 无显著相关性。SV、SI、CO、ACI 和 LVET 与 BNP 呈负相关。SVR、PEP 和 STR 与 BNP 呈正相关(P<0.05)。
在接受 OPCABG 的患者中,ICG 结果与 BNP 水平和超声心动图评估心脏血流动力学变化的结果显著相关。ICG 可能在临床实践中对评估心脏功能具有一定作用。