scholarly journals Ultrastructural characteristics of erythrocytes and their relationship with oxygen transport in patients with ischemic heart disease after coronary artery bypass grafting with artificial circulation

2021 ◽  
pp. 70-77
Author(s):  
E. A. Sergeev ◽  
M. E. Shmelev ◽  
B. I. Geltser ◽  
V. N. Kotelnikov
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ischemic Heart Disease ◽  
Coronary Artery Bypass ◽  
Oxygen Transport ◽  
Artery Bypass ◽  
Erythrocyte Membranes ◽  
Bypass Grafting ◽  
Artificial Circulation

Aim. Evaluation of nanostructural and micromechanical characteristics of erythrocytes and their relationship with the parameters of oxygen transport in patients with ischemic heart disease (IHD) after coronary artery bypass grafting (CABG) under artificial circulation (AC).Materials and methods. The study involved 30 men with IHD aged 53 to 67 years with a median of 63 years, who underwent planned CABG with AC at the clinic of the Far Eastern Federal University. Blood sampling from patients was carried out before the AC and one day after it from a venous catheter located in the right atrium. Erythrocytes were scanned using a Bioscope Catalyst atomic force microscope (AFM) (Bruker, USA) in combination with an Axiovert 200 inverted microscope (Zeiss, Germany). The micromechanical properties of cell membranes were investigated with the PFQNM-LC-A-CAL cantilevers. The following were recorded: the diameter of erythrocytes, the height of their side, area, volume, membrane rigidity, strength of its adhesion, Young's modulus, elastic deformation. To assess oxygen transport, the oxygen delivery index (DO2I), consumption (VO2I), and extraction ratio (O2ER) were calculated.Results. In one day after CABG, a decrease in DO2I, VO2I, and O2ER was recorded by 14%, 33%, and 16%, respectively, which indicated a limitation in the gas transport function of the blood. Analysis of the AFM characteristics of erythrocytes showed an increase in their area by 35%, in diameter by 6%, in volume by 19%, and the height of the side by 5 times. At the same time, multidirectional changes in the micromechanical properties of erythrocyte membranes were noted: Young's modulus and stiffness decreased by 3.2 and 2 times, respectively; the adhesion force increased by 2.7 times, and the elastic deformation – by 2.2 times. Correlation analysis showed the presence of reliable relationships between indicators of oxygen transport and biomechanical parameters of erythrocyte membranes.Conclusion. A comprehensive analysis of the nanostructural parameters of erythrocytes and oxygen transport expands the understanding of the pathophysiological mechanisms of postperfusion disorders in patients with coronary artery disease after CABG under conditions of cardiopulmonary bypass.

Factors Associated With Immediate Results of Coronary Artery Bypass Grafting in Patients With Ischemic Heart Disease in the Presence of Type 2 Diabetes

Kardiologiia ◽  
2016 ◽  
Vol 10_2016 ◽  
pp. 13-21 ◽  
Author(s):  
A.N. Sumin Sumin ◽  
N.A. Bezdenezhnyh Bezdenezhnyh ◽  
A.V. Bezdenezhnyh Bezdenezhnyh ◽  
S.V. Ivanov Ivanov ◽  
O.L. Barbarash Barbarash ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ischemic Heart Disease ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Factors Associated

scholarly journals DIAGNOSTICS AND INTENSIVE CARE OF HEART FAILURE IN PATIENTS WHO UNDERWENT CORONARY ARTERY BYPASS GRAFT SURGERY WITH ARTIFICIAL CIRCULATION

2021 ◽  
Vol 4 (18) ◽  
pp. 4-9
Author(s):  
V.I. Cherniy ◽  
Y.V. Kurylenko
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artificial Circulation

Abstract. Introduction. Coronary heart disease, the complexity of the surgery conducted, inflammatory reaction to extracorporeal circulation and the need for perioperative anticoagulation influence perioperative state of hemodynamics during the surgical revascularization of a myocardium in patients with coronary heart disease. The aim. To improve the results of treatment of cardiac surgery patients with heart failure who underwent surgery, namely, coronary artery bypass grafting using extracorporeal circulation by improving methods of diagnosing heart failure. Materials and methods. 100 cardiac surgery patients with coronary heart disease were operated on at State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. In all the cases, coronary artery bypass grafting was performed using artificial circulation. In patients of group 1 (40 patients) in the postoperative period, the correction of hemodynamic disorders was performed according to the standard protocol. In group 2 (60 patients) - a differentiated approach to the correction of hemodynamic disorders was used. Results. It was found that in group 2 for stabilization of hemodynamics, oxygen status, microcirculation, smaller doses of sympathomimetics and shorter duration of their use, P <0.05 than in 1 were applied. Conclusions. The results of the studies indicate the possibility of using the method of phasography, in particular, the analysis of symmetry of the T wave, as a marker of ischemic changes in the myocardium in cardiac patients who underwent coronary artery bypass grafting using artificial circulation. The obtained data show that the developed algorithm of perioperative management of cardiac surgery patients with heart failure makes it possible to significantly accelerate the rehabilitation of cardiac surgery patients, increase patient comfort and reduce the length of their hospitalization. The possibility of using phasography for monitoring of myocardial condition in patients undergoing coronary artery bypass surgery has been investigated.

scholarly journals Hemodynamic status of patients with different comorbidities of ischemic heart disease before and after coronary artery bypass grafting

2021 ◽  
Vol 20 (3) ◽  
pp. 29-37
Author(s):  
B. I. Geltser ◽  
E. A. Sergeev ◽  
V. N. Kotelnikov ◽  
A. A. Silaev ◽  
R. S. Karpov
Keyword(s):  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Ischemic Heart Disease ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Before And After

Aim. To assess the hemodynamic status by transpulmonary thermodilution (TPTD) in patients with ischemic heart disease (IHD) with different comorbidities before and after coronary artery bypass grafting (CABG).Materials and methods. 66 patients with IHD (40 men and 26 women) aged 53 to 77 years who were admitted for planned CABG were examined. The patients were divided into three groups according to the comorbidity: cardiovascular, respiratory, and metabolic. The first comorbidity was represented by a combination of IHD and multifocal atherosclerosis, the second – by IHD and chronic obstructive pulmonary disease (COPD), and the third – by IHD and metabolic syndrome (MS). All patients underwent CABG with the use of cardiopulmonary bypass. Hemodynamic parameters were recorded by the TPTD method using the Pulsion Picco Plus module (Germany) at 3 stages: after the start of mechanical ventilation (stage I), after the completion of cardiopulmonary bypass (stage II), and 24 hours after CABG (stage III).Results. The patients with IHD with different comorbidities differed in characteristic signs of hemodynamic changes. In IHD with comorbid COPD, after withdrawal from the cardiopulmonary bypass and 24 hours after CABG, the highest index of systemic vascular resistance, the minimum values of the global ejection fraction, and a decrease in the global end-diastolic volume and pulmonary blood volume less noticeable compared with other groups of patients were noted. With comorbid respiratory and metabolic disorders, the maximum values for the indices of extravascular lung water and pulmonary vascular permeability were recorded. In the patients with a comorbid cardiovascular disease, hemodynamic and volume status violations in the dynamic follow-up were less pronounced.Conclusion. The use of the TPTD method in patients with IHD before and after CABG makes it possible to specify the functional state of the circulatory system in different comorbidities, which increases the effectiveness of risk stratification and the accuracy of predicting possible complications.

Sign in / Sign up

Export Citation Format

Share Document