Skeletal muscle status, autonomic balance and short-term results of cardiac surgery

Abstract

Purpose — To study the association between the status of lower extremities’ skeletal muscles and autonomic balance with the short-term results of cardiac surgery patients. Methods — 64 patients (57 men, median age 63 years) who underwent non-urgent cardiac surgery at the Research Institute for Complex Issues of Cardiovascular Diseases clinic from March 2015 to March 2016 were included in the study. Patients with exacerbation of underlying disease were excluded from the study. Additionally, muscle status of the patients was assessed using static-dynamic tests on a multifunctional training apparatus, and the autonomic nervous system (ANS) state was evaluated using the ORTOexpert program during an active orthostatic test. 9 patients developed complications in the postoperative period; groups with the postoperative complications present and absent were compared according to the studied preoperative indicators. Results — The following indicators were revealed more often prior to the surgery in the group with the postoperative complications: cardiac arrhythmias (p=0.023), aortic valve regurgitation (p=0.002), left ventricle aneurysm (p=0.007), carotid stenosis (p=0.036), decreased muscle strength of the upper and lower extremities (p=0.047 and p=0.046), sympathetic activation (LF/HF ratio p=0.028), and ANS stress in response to the test. Conclusion — Low status of skeletal muscles (upper and lower extremities) and ANS sympathetic activation and the overstrain of its adaptive mechanisms were associated with development of postoperative complications after cardiac surgery, along with severity of the underlying cardiac pathology, risk and duration of the surgery.

Keywords

• cardiac surgery
• postoperative complications
• muscle status
• autonomic status