Cardiovascular Dynamics Following Open Heart Surgery: Early Impairment and Potential for Recovery

  • Robert Bauernschmitt
  • Niels Wessel
  • Hagen Malberg
  • Gernot Brockmann
  • Jürgen Kurths
  • Georg Bretthauer
  • Rüdiger Lange
Part of the Understanding Complex Systems book series (UCS)

Abstract

Heart rate variability (HRV) and baroreflex sensitivity (BRS) are severely altered during the postoperative course of patients undergoing cardiovascular surgery. This study was performed to evaluate the response of the autonomic regulation in patients undergoing cardiac surgery with a special emphasis on the potential for recovery.

Keywords

Heart rate variability Baroreflex sensitivity Cardiac surgery Postoperative autonomic regulation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    D. Wichterle, J. Simek , M.T. La Rovere, P.J. Schwartz, A.J. Camm, M. Malik, Prevalent low-frequency oscillation of heart rate: novel predictor of mortality after myocardial infarction, Circulation 110, 1183–1190(2004)PubMedCrossRefGoogle Scholar
  2. 2.
    M. T. La Rovere, G. D. Pinna, S. H. Hohnloser, F. I. Marcus, A. Mortara, R. Nohara, J. T. Bigger Jr, A. J. Camm, P. J. Schwartz, ATRAMI investigators. Autonomic tone and reflexes after myocardial infarction. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials. Circulation 103, 2072–2077(2001)Google Scholar
  3. 3.
    H. Malberg, R. Bauernschmitt, U. Meyerfeldt, A. Schirdewan, N. Wessel, Short-term heart rate turbulence analysis versus variability and baroreceptor sensitivity in patients with dilated cardiomyopathy. Z. Kardiol. 92, 547–557 (2003) translation in: Ind. Pacing Electrophysiol. J. 4, 162–175(2004)PubMedCrossRefGoogle Scholar
  4. 4.
    C. A. Brown, L. A. Wolfe, G. Hains, G. Ropchan, J. Parlow, Spontaneous baroreflex sensitivity after coronary artery bypass graft surgery as a function of gender and age. Can. J. Physiol. Pharmacol. 9, 894–902(2003)CrossRefGoogle Scholar
  5. 5.
    R. Bauernschmitt, H. Malberg, N. Wessel, B. Kopp, E. U. Schirmbeck, R. Lange, Impairment of cardiovascular autonomic control in patients early after cardiac surgery. Eur. J. Cardiothorac. Surg. 25(3), 320–326(2004)PubMedCrossRefGoogle Scholar
  6. 6.
    H. Malberg, N. Wessel, A. Hasart, K. J. Osterziel, A. Voss, Advanced analysis of the spontaneous baroreflex sensitivity, blood pressure and heart rate variability in patients with dilated cardiomyopathy. Clin. Sci. 102, 465–473(2002)PubMedCrossRefGoogle Scholar
  7. 7.
    Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology. European Heart Journal 17, 354–381(1996)Google Scholar
  8. 8.
    J. Kurths, A. Voss, A. Witt, P. Saparin, H. J. Kleiner, N. Wessel, Quantitative analysis of heart rate variability. Chaos 5, 88–94(1995)PubMedCrossRefGoogle Scholar
  9. 9.
    A. Voss, J. Kurths, H. J. Kleiner, A. Witt, N. Wessel, P. Saparin, K. K. Osterziel, R.Schurath, R. Dietz, The application of methods of non-linear dynamics for the improved and predictive recognition of patients threatened by sudden cardiac death. Cardiovasc. Res. 31,419–433(1996)PubMedGoogle Scholar
  10. 10.
    M. J. Niemela, K. E .J. Airaksinen, K. U. O. Tahvanainen, M. K. Linnaluoto, J. T. Takkunen, Effect of coronary artery bypass grafting on cardiac parasympathetic nervous function. Eur. Heart J. 13, 932–935(1992)PubMedGoogle Scholar
  11. 11.
    Z. K. Wu, S. Vikman, J. Laurikka, E. Pehkonen, T. Iivainen, H. V. Huikuri, M. R. Tarkka, Nonlinear heart rate variability in CABG patients and the preconditioning effect. Eur. J. Cardiothorac. Surg. 28(1), 109–113(2005)PubMedCrossRefGoogle Scholar
  12. 12.
    T. T. Laitio, H. V. Huikuri, E. S. Kentala, T. H. Makikallio, J. R. Jalonen, H. Helenius, K.Sariola-Heinonen, S. Yli-Mayry, H. Scheinin, Correlation properties and complexity of perioperative RR-interval dynamics in coronary artery bypass surgery patients. Anesthesiology 93, 69–80(2000)PubMedCrossRefGoogle Scholar
  13. 13.
    C. W. jr Hogue, P. K. Stein, I. Apostolidou, D. G. Lappas, R. E. Kleiger, Alterations in temporal patterns of heart rate variability after coronary artery bypass graft surgery. Anesthesiology 81, 1356–1364(1994)Google Scholar
  14. 14.
    C. D. Kuo, G. Y. Chen, S. T. Lai, Y. Y. Wang, C. C. Shih, J. H. Wang, Sequential changes in heart rate variability after coronary artery bypass grafting. Am. J. Cardiol. 83,776–779(1999)PubMedCrossRefGoogle Scholar
  15. 15.
    F. Beckers, D. Ramaekers, G. Speijer, H. Ector, J. Vanhaecke, J. B. Verheyden, J.VanCleemput, W. F. Droogne, F. Van de Werf, A. E. Aubert, Different evolutions in heart rate variability after heart transplantation: 10-year follow-up. Transplantation 10,1523–1531(2004)CrossRefGoogle Scholar
  16. 16.
    P. K. Smith, M. Carrier, J. C. Chen, A. Haverich, J. H. Levy, P. Menasche, S. K. Shernan, F. Van de Werf, P. X. Adams, T. G. Todaro, E. Verrier, Effect of pexelizumab in coronary artery bypass graft surgery with extended aortic cross-clamp time. Ann. Thorac. Surg. 82(3), 781–788(2006)PubMedCrossRefGoogle Scholar
  17. 17.
    N. Wessel, Ch. Ziehmann, J. Kurths, U. Meyerfeldt, A. Schirdewan, A. Voss, Short-term forecasting of life-threatening cardiac arrhythmias based on symbolic dynamics and finite-time growth rate. Phys. Rev. E 61, 733–739(2000)CrossRefGoogle Scholar
  18. 18.
    A. Elan, D. P. Zipes, Right ventricular infarction causes heterogeneous autonomic denervation of the viable peri-infarct area. Circulation 97(5), 484–492(1998)Google Scholar
  19. 19.
    F. Biancari, O. P. Kangasniemi, J. Luukkonen, S. Vuorisalo, J. Satta, R. Pokela, T. Juvonen, EuroSCORE predicts immediate and late outcome after coronary artery bypass surgery. Ann. Thorac. Surg. 82(1), 57–61(2006)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Robert Bauernschmitt
    • 1
  • Niels Wessel
  • Hagen Malberg
  • Gernot Brockmann
  • Jürgen Kurths
  • Georg Bretthauer
  • Rüdiger Lange
  1. 1.Department of Cardiovascular SurgeryGerman Heart CentreGermany

Personalised recommendations