Vladimir A Shvartz
1 
, Anton R Kiselev
1,2,3* , Anatoly S Karavaev
3,4 , Kristina A Vulf
1 , Ekaterina I Borovkova
3 , Mikhail D Prokhorov
4 , Andrey D Petrosyan
1, Olga L Bockeria
1 1 Department of Surgical Treatment for Interactive Pathology, Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
2 Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University, Saratov, Russia
3 Department of Nano- and Biomedical Technologies, Saratov State University, Saratov, Russia
4 Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
*Corresponding Author: Saratov State University Email antonkis@list.ru
Abstract
Introduction: Our aim was to perform a comparative study of short-term cardiovascular autonomic control in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or surgical correction of valvular heart disease (SCVHD).
Methods: The synchronous 15 minutes records of heart rate variability (HRV) and finger’s photoplethysmographic waveform variability (PPGV) were performed in 42 cardiac surgery patients (12 women) aged 61.8 ± 8.6 years (mean ± standard deviation), who underwent CABG, and 36 patients (16 women) aged 54.2 ± 14.9 years, who underwent SCVHD, before surgery and in 5-7 days after surgery. Conventional time and frequency domain measures of HRV and index S of synchronization between the slow oscillations in PPGV and HRV were analyzed. We also calculated personal dynamics of these indices after surgery.
Results: We found no differences (Р > 0.05) in all studied autonomic indices (preoperative and post-surgery) between studied patients’ groups, except for the preoperative heart rate, which was higher in patients who underwent SCVHD (P = 0.013). We have shown a pronounced preoperative and post-surgery variability (magnitude of inter-quartile ranges) of all autonomic indices in studied patients. In the cluster analysis based on cardiovascular autonomic indices (preoperative and post-surgery), we divided all patients into two clusters (38 and 40 subjects) which did not differ in all clinical characteristics (except for the preoperative hematocrit, P = 0.038), index S, and all post-surgery HRV indices. First cluster (38 patients) had higher preoperative values of the HR, TP, HF, and HF%, and lower preoperative values of the LF% and LF/HF.
Conclusion: The variability of cardiovascular autonomic indices in on-pump cardiac surgery patients (two characteristic clusters were identified based on preoperative indices) was not associated with their clinical characteristics and features of surgical procedure (including cardioplegia).