STRUCTURAL AND FUNCTIONAL CHANGES OF THE MYOCARDIUM AFTER CORONARY ARTERY BYPASS GRAFTING IN OVERWEIGHT PATIENTS AT DIFFERENT STAGES OF REHABILITATION
Background. The global role of fatal complications of cardiovascular diseases is of great importance, since they are the leading cause in the structure of total mortality of the entire population. Extensive use of interventional and reconstructive methods has made it possible to make progress in the treatment of cardiovascular diseases, ensuring the restoration of blood flow in the arteries of the myocardium. However, at the stage of rehabilitation after the restoration of coronary blood flow, serious problems arise associated with post-revascularization complications and remodeling of the heart.
The aim of the study was to study the structural and functional changes of the myocardium in overweight patients after coronary artery bypass grafting in dynamics at the stages of rehabilitation.
Materials and methods: The cohort study included 97 patients hospitalized at the Regional Cardiac Surgery Center, and Tulpar Cardio Rehabilitation Center in Karaganda, who were treated from February to September 2021. The patients were divided into 2 groups: group 1 (main group) - overweight patients after coronary artery bypass grafting (n=54) and group 2 (comparison group) - patients with normal body weight after coronary artery bypass grafting (n=43). The patients were examined on the first day after blood flow was restored at the regional cardiac surgery center, then at the 1st, 2nd and 3rd stages of cardiac rehabilitation at the Tulpar center. The patients underwent a clinical examination: a survey of complaints, physical examination with anthropometry, determination of body mass index. Among the instrumental research methods, an electrocardiogram (ECG) in 12 standard leads and transthoracic echocardiography (echocardiography) were used. Statistical analysis of the data was carried out using the STATISTICA 12 software. The nonparametric Kraskel-Wallis criterion was used to compare continuous values, and the Spearman correlation coefficient was used for correlation analysis. The differences were considered statistically significant at p<0.05.
Results: in overweight patients after coronary artery bypass grafting, the mass index of the left ventricular myocardium, the relative wall thickness gradually decreases at the first and second stages of rehabilitation, increases again at the third stage of rehabilitation.
Conclusions: despite the good dynamics at the first and second stages of rehabilitation, we did not observe a positive dynamics of structural changes in the myocardium at the third stage of rehabilitation in overweight patients who underwent coronary artery bypass grafting.
Aizhan N. Seytekova1*, https://orcid.org/0000-0003-4501-2454
Vilen B. Molotov-Luchanskiy1, https://orcid.org/0000-0001-8473-4375
Zarina K. Kavkenova1, https:// orcid.org/0009-0004-8836-9116
1 Karaganda Medical University, Karaganda, Republic of Kazakhstan.
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Seytekova A.N., Molotov-Luchanskiy V.B., Kavkenova Z.K. Structural and functional changes of the myocardium after coronary artery bypass grafting in overweight patients at different stages of rehabilitation // Nauka i Zdravookhranenie [Science & Healthcare]. 2024. Vol.26 (2), pp. 45-52. doi 10.34689/SH.2024.26.2.006Related publications:
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