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一项对比研究考察了非体外循环下冠状动脉旁路移植术对不同类型冠心病患者心功能和心脏结构的影响。

A comparative study examining the impact of coronary artery bypass grafting surgery with non-extracorporeal circulation on heart function and structure in patients with various forms of coronary heart diseases.

机构信息

Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Ningxia, China.

Department of Cardiovascular Medicine, General Hospital of Ningxia Medical University, Ningxia, China.

出版信息

Medicine (Baltimore). 2024 Jul 19;103(29):e38844. doi: 10.1097/MD.0000000000038844.

Abstract

The aim of this study is to assess alterations in heart function and structure in patients diagnosed with non-ST segment elevation acute myocardial infarction (NSTEAMI), unstable angina (UA), and stable angina (SA) 1 year after undergoing off-pump coronary artery bypass grafting (OPCABG) performed without extracorporeal circulation. A total of 182 patients who underwent OPCABG were included and classified into 3 groups based on their preoperative diagnosis: the NSTEAMI group (n = 68), the UA group (n = 64), and the SA group (n = 50). Cardiac ultrasonography data were collected for all groups both preoperatively and 1 year postoperatively. Clinical data were subjected to statistical analysis. In the NSTEAMI group, postoperative observations revealed increases in left ventricular stroke volume and left ventricular end-systolic diameter, along with reductions in left ventricular end-diastolic volume (LVEDV) and left ventricular end-diastolic diameter (LVEDD) 1-year post-surgery. The UA group demonstrated decreases in LVEDV and LVEDD 1-year post-surgery. Similarly, the SA group exhibited an increase in left ventricular ejection fraction (LVEF) and reductions in LVEDV and LVEDD 1-year post-surgery. Comparative analysis of cardiac ultrasonography data revealed that the NSTEAMI group displayed significantly lower left ventricular stroke volume and notably higher left ventricular end-systolic diameter and volume compared to the UA and SA groups 1-year post-surgery. Furthermore, the SA group exhibited significantly elevated LVEF compared to the UA and NSTEAMI groups 1-year post-surgery. Cardiac ultrasonography findings indicate that all 3 groups exhibited improvements in cardiac function and left ventricular structure 1-year post-surgery. However, the NSTEAMI group demonstrated more substantial improvements in comparison to the UA and SA groups.

摘要

本研究旨在评估非 ST 段抬高急性心肌梗死(NSTEAMI)、不稳定型心绞痛(UA)和稳定型心绞痛(SA)患者在接受非体外循环下冠状动脉旁路移植术(OPCABG)治疗 1 年后心脏功能和结构的变化。共纳入 182 例行 OPCABG 的患者,根据术前诊断分为 3 组:NSTEAMI 组(n=68)、UA 组(n=64)和 SA 组(n=50)。所有组均在术前和术后 1 年采集心脏超声数据。对临床数据进行统计学分析。NSTEAMI 组术后观察到左心室每搏量和左心室收缩末期直径增加,左心室舒张末期容积(LVEDV)和左心室舒张末期直径(LVEDD)减少。UA 组术后 1 年 LVEDV 和 LVEDD 减少。同样,SA 组术后左心室射血分数(LVEF)增加,LVEDV 和 LVEDD 减少。心脏超声数据比较分析显示,NSTEAMI 组术后 1 年左心室每搏量明显低于 UA 和 SA 组,左心室收缩末期直径和容积明显高于 UA 和 SA 组。此外,SA 组术后 1 年 LVEF 明显高于 UA 和 NSTEAMI 组。心脏超声检查结果表明,所有 3 组术后 1 年均有心脏功能和左心室结构改善,但 NSTEAMI 组改善程度明显优于 UA 和 SA 组。

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