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首页> 外文期刊>Journal of cardiac surgery. >Functional assessment of improvement of myocardial ischemia using coronary flow velocity reserve after coronary artery bypass surgery in hemodialysis
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Functional assessment of improvement of myocardial ischemia using coronary flow velocity reserve after coronary artery bypass surgery in hemodialysis

机译：血液透析冠状动脉旁路手术冠状动脉旁路手术中使用冠状动脉速率储备改善心肌缺血的功能评估

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摘要

Abstract Background In patients with end‐stage renal disease requiring hemodialysis (HD patients), myocardial ischemia after coronary artery disease is a major cause of mortality. Coronary pathophysiology, namely myocardial microvascular dysfunction, appears to differ from patients not requiring HD (non‐HD patients). Objectives We compared functional improvement of myocardial ischemia after coronary artery bypass surgery (CABG) between HD and non‐HD patients by transthoracic coronary flow velocity reserve (CFVR). Methods We retrospectively reviewed isolated CABG patients from between 2008 and 2017. Finally, 161 patients were enrolled; each underwent pre‐ and postoperative CFVR assessment, and left anterior descending (LAD) artery revascularization with “in‐situ” internal mammary artery (IMA). Graft patency was confirmed, and after successful CABG, postoperative CFVR improvement between the two groups was compared. Results Preoperative CFVR value in group H was 1.81?±?0.52, group N was 1.93?±?0.66. There was no significant difference between the groups. IMA to LAD grafts were patent in postoperative evaluation in all patients. Postoperative CFVR in group H was 2.48?±?0.72 and group N was 2.83?±?0.73 ( P ?=?.042). Significant difference was observed. Conclusion In both groups, CFVR values improved after successful CABG, but postoperative CFVR values were significant different. In younger populations CFVR values are generally higher. Our HD group was significantly younger than the non‐HD group, but CFVR values were postoperatively significantly lower. CFVR values are reportedly affected by both epicardial and microcoronary circulation. In this study population, as all grafts to the LAD were patent, the lower CFVR value in the HD group was considered to have resulted in microvascular disorders.
机译：摘要背景患者患有血液透析（高清患者）的末期肾病（HD患者），心肌缺血冠状动脉疾病后是死亡的主要原因。冠状动脉病理生理学，即心肌微血管功能障碍似乎与不需要HD（非高清患者）的患者不同。目的我们在HD和非高清患者之间进行了冠状动脉旁路手术（CABG）经冠状动脉冠状动脉速率储备（CFVR）比较了冠状动脉旁路手术（CABG）的功能改善。方法从2008年至2017年间回顾性审查孤立的CABG患者。最后，161名患者注册;每个接受术后和术后CFVR评估，以及左前期下降（LAD）动脉血运重建与“原位”内部乳腺动脉（IMA）。确认接枝通畅，并在成功后，比较两组之间的术后CFVR改善。结果术前CFVR值在h族中为1.81？±0.52，N族为1.93？±0.66。组之间没有显着差异。在所有患者的术后评估中，Lad移植物的IMA是专利。 H组术后CFVR为2.48？±0.72和N为2.83？±0.73（p？= _. 042）。观察到显着差异。结论在两组中，CFVR值在成功后改善，但术后CFVR值是显着的。在较年轻的人口中，CFVR值通常更高。我们的HD组比非高清组大大变得小，但CFVR值术后明显降低。据报道，CFVR值受外形和微循环的影响。在本研究中，随着所有移植物的群体是专利，HD组中的下部CFVR值被认为是导致微血管障碍。

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  • 来源
    《Journal of cardiac surgery.》 |2019年第8期|共7页
  • 作者

    Honda Kentaro; Yuzaki Mitsuru; Kaneko Masahiro; Funahashi Ryosuke; Kunimoto Hideki; Fujimoto Takahiro; Nakanishi Yasuka; Agematsu Kota; Nagashima Mitsugi; Nishimura Yoshiharu;

  • 作者单位

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

    Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayama Japan;

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  • 正文语种 eng
  • 中图分类 心脏血管和淋巴系外科学;
  • 关键词

    CABG; CFVR; hemodialysis; microvascular dysfunction;

    机译：CABG;CFVR;血液透析;微血管功能障碍;

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