APPLICATION OF INTERVALIC HYPOXIC-HYPEROXIC ENTRAINMENT TO PREVENTION OF INTRA AND EARLY POSTOPERATIONAL COMPLICATIONS IN CORONARY BYPASS GRAFTING

Abstract

Aim. To assess possibility and safety of intervalic hypoxic-hyperoxic training (HHT) as a method of cardioprotection and metabolic adaptation of myocardium for onpump coronary bypass surgery.Material and methods. Totally, 80 coronary heart disease patients included, hospitalized to the clinics of aortic and cardiosurgery of the University hospital of Sechenov University. All had indications for the operation — direct myocardial revascularization with bypass grafting. In 5 days before surgery, according to the scheme of preparation, the patients were randomized to two groups (main — with HHT, and controls; n=40). The rate of complications was evaluated, during the operation and in post-surgery period. The level of troponin I was measured before operation, in 2 and 24 hours after, as well as level of lactate in venous blood before and after operation.Results. The rate of intraand early postsurgery complications in both groups did not differ significantly, though in the main there was tendency to decline of total rate of complications. In patients of HHT group median troponin I was significantly lower: 1,068 (0,388; 1,397) ng/L, when in controls — 1,980 (1,068; 3,239) ng/mL, р=0,012.Lactate level after HHT operation was significantly lower — 1,74 (1,23; 2,04) mM/L, comparing to the controls — 2,10 (1,80; 2,29) mM/L, р=0,04.Conclusion. The applicability and safety were demonstrated, of HHT as a method of cardioprotection in shunting of coronary arteries on-pump. Taken low number of participants, it is important to conduct broader investigation on this type of entrainment.

Keywords

• coronary bypass
• hypoxic preconditioning
• intervalic hypoxic-hyperoxic training