Matusik Patrycja S, Alomar Omar, Hussain Maryam Rafaqat, Akrmah Muhammad, Matusik Paweł T, Chen Daniel M, Alomar Muhammed, Stein Phyllis K
Chair of Radiology, Jagiellonian University Medical College and University Hospital, 30-688 Kraków, Poland.
Heart Rate Variability Laboratory, Cardiovascular Division, Department of Medicine, Washington University School of Medicine in St. Louis, Saint Louis, MO 63130, USA.
Rev Cardiovasc Med. 2024 Jan 22;25(1):36. doi: 10.31083/j.rcm2501036. eCollection 2024 Jan.
Coronary artery bypass grafting (CABG) is a well-established surgical procedure used to treat significant coronary artery disease. Nevertheless, unfavorable cardiovascular events and complications, including cardiac arrhythmias may be observed in patients after CABG. Previous studies have revealed a relationship between risk of cardiac arrhythmias and abnormal heart rate variability (HRV), which reflects adverse alterations in cardiac autonomic functioning, that may occur in patients after a CABG procedure. The aim of this article was to provide a systematic review of the major research findings in this area.
A literature search was carried out using PubMed, Cochrane, and Embase databases and relevant articles, published in English, were analyzed in detail.
Studies performed so far have shown time depending changes in HRV after CABG. Time and frequency domain HRV decrease acutely after CABG but recover almost completely to pre-operative values by 6 months after surgery. Some preoperative clinical states such as: heart failure, type 2 diabetes mellitus and depression adversely affect post-CABG HRV. Finally, post-CABG cardiac rehabilitation appears to improve exercise capacity and speed up recovery of HRV.
Generally, traditional time and frequency domain HRV parameters fail to predict complications post-CABG. Altered non-linear measures of HRV may identify subgroups of subjects at increased risk of potential complications, including atrial fibrillation post-CABG. However, data available currently does not appear to unequivocally support the hypothesis that early HRV assessment in post-CABG patients predicts long-term mortality.
冠状动脉旁路移植术（CABG）是一种成熟的用于治疗严重冠状动脉疾病的外科手术。然而，在CABG术后的患者中可能会观察到不良心血管事件和并发症，包括心律失常。先前的研究揭示了心律失常风险与异常心率变异性（HRV）之间的关系，HRV反映了心脏自主功能的不良改变，这种改变可能发生在CABG手术患者身上。本文的目的是对该领域的主要研究结果进行系统综述。
使用PubMed、Cochrane和Embase数据库进行文献检索，并对以英文发表的相关文章进行详细分析。
迄今为止进行的研究表明，CABG术后HRV存在随时间的变化。CABG术后时域和频域HRV急性下降，但在术后6个月几乎完全恢复到术前值。一些术前临床状态，如心力衰竭、2型糖尿病和抑郁症，会对CABG术后的HRV产生不利影响。最后，CABG术后心脏康复似乎可以提高运动能力并加速HRV的恢复。
一般来说，传统的时域和频域HRV参数无法预测CABG术后的并发症。HRV的非线性测量指标改变可能会识别出潜在并发症风险增加的受试者亚组，包括CABG术后房颤。然而，目前可得的数据似乎并未明确支持CABG术后患者早期HRV评估可预测长期死亡率这一假设。
