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Efficacy of Valerian Extract on Sleep Quality after coronary artery bypass graft Surgery: A Triple-Blind Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2021年第1期27卷 7-15页

作者： Halimeh khaton Zare Elmi Mohammad Gholami Mandana Saki Farzad Ebrahimzadeh Student Research Committee Lorestan University of MedicalSciencesKhorramabad(***)Iran School of Nursing and Midwifery Lorestan University of Medical SciencesKhorramabad(***)Iran Social Determinantsof Health Research Center Lorestan University of MedicalSciencesKhorramabad(***)Iran Department of Biostatistics and Epidemiology School of Health and NutritionLoreatan Univeraity of Medical GcienceaKhorramabad(***)Iran

Objective:To assess the effect of valerian root extract on the sleep quality of patients after coronary artery bypass graft(CABG)***:The patients who participated in this triple-blind clinical trial were selected by permuted block *** participants were assigned to the valerian(n=36)and placebo(n=36)*** valerian group received 530 mg of valerian capsules for 30 nights after CABG surgery,and the placebo group received 530 mg of the placebo capsules containing wheat *** Pittsburgh Sleep Quality Index(PSQI),the prothrombin time(PT)and partial thromboplastin time(PTT)were assessed on four occasions,including the baseline,the 3 rd,14 th and 30 th days following ***:The odds ratio of worsened sleep quality significantly varied over time(the interaction of time and group)in the valerian group compared to the placebo group in various dimensions including total sleep quality(P=0.001),sleep latency(P<0.01),sleep duration(P=0.020),sleep efficiency(P=0.001)and daytime dysfunction(P=0.025).No significant difference was observed in the alterations of the odds ratio of PT in the two groups over time.(P=0.371).Conclusion:The consumption of oral valerian root extract over 30 nights could significantly improve the patients'sleep quality safely after CABG surgery.

关键词： coronary artery bypass graft herbal medicine randomized controlled trial sleep quality valerian

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Predictors of atrial fibrillation after coronary artery bypass graft： a meta-analysis

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Journal of Geriatric Cardiology 2009年第3期6卷 162-167页

作者： Liang Yin Zhi-Nong Wang Yi-Feng Wang Wen-Tao Wang Guang-Yu Ji Xin-Wei Yang Zhi-Yun Xu Department of Cardiothoracic Surgery Changhai Hospital Second Military Medical University of PLA Shanghai 200433 China

Objectives Postoperative atrial fibrillation （AF） has been associated with less favorable outcomes in patients undergoing coronary artery bypass graft surgery （CABG） and may result in increased post-operative morbidity and mortality. A systematic review and meta-analysis of published studies was conducted to examine the risk factors of occurrence AF after CABG. Methods Using the Medline database, the Cochrane clinical trials database and online clinical trial databases, we reviewed all randomized controlled trials （RCTs） and observational studies examining the risk factors of occurrence of AF after CABG. We searched for literature published April 2009 or earlier. Results Our review identified 8 studies （observational studies）, involving 14548 patients, that examined the risk factors of occurrence of AF after CABG. Although studies provide conflicting results, the overall outcomes suggests that advanced age, previous hypertension, numbers of bridge vessels may increase the occurrence of AF after CABG, while no significant difference of diabetes, preoperative myocardial infarction, and preoperative medication of 13 -Blocker have been observed between the AF patients and no-AF patiens. Conclusions Patients with advanced age, previous hypertension and more numbers of bridge vessels had higher risk for the occurrence of AF after CABG, and perioperative medication and care must be intensified to decrease the postoperative occurrence ofAF（J Geriatr Cardio12009; 6：162-167）.

关键词： atrial fibrillation coronary artery bypass graft postoperative meta-analysis predictors

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Predictors of new-onset atrial fibrillation in elderly patients with coronary artery disease after coronary artery bypass graft

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Journal of Geriatric Cardiology 2016年第5期13卷 444-449页

作者： Rubanenko O Anatol'evna Fatenkov O Veniaminovic Khokhlunov S Mikhaylovich Department of Faculty Therapy Samara State Medical Universtty Samara Russia Samara Regional Cardiology Centre Samara Russia

Objective To identify the factors associated with the development of postoperative atrial fibrillation （POAF） after coronary artery bypass graft （CABG） in elderly patients with coronary artery disease （CAD）. Methods A total of 81 patients with CAD who underwent CABG were enrolled in the study. Patients were divided into two groups： Group 1, without postoperative atrial fibrillation （59 patients, 74.6% men, mean age 65.8 ~ 4.0 years）; Group 2, with early new-onset atrial fibrillation after CABG （22 patients, 90.9% men, mean age 67.7 ＋ 5.4 years）. Interleukin （IL）-6, IL-8, IL-10, C-reactive protein （CRP）, fibrinogen, superoxide dismutase （SOD）, N-terminal pro-B-type natriuretic peptide （NT-proBNP）, and troponin I were studied. Results During the observation period, atrial fibrillation occurred in 27.2% cases, an average of 4.9 ±3.8 days after surgery. In group 2, the left atrium （LA） dimension was larger than in group 1 （43.9 ± 3.4 mm vs. 37.6 ±3.9 rnm, P 〈 0.001）. Patients with POAF had significantly higher IL-6 （72.7 ±60.8 pg/mL vs. 38.0 ± 34.6 pg/mL, P = 0.04）, IL-8 （11.9 ± 6.0 pg/mL vs. 7.7± 5.4 pg/mL, P = 0.01） and SOD （2462.0 ± 2029.3 units/g vs. 1515.0 ± 1292.9 units/g, P = 0.04） compared with group without POAF. The multivariate analysis showed that the odds ratio （OR） for POAF development in patients with left atrium more than 39 mm was 2.1 [95% confidence interval （CI）： 1.2-3.8, P = 0.0004], IL-6 levels more than 65.18 pg/mL-1.4 （95% Ch 1.1-2.7, P = 0.009）, IL-8 levels more than 9.67 pg/mL-1.2 （95% CI： 1.1-3.7, P ： 0.009）, SOD more than 2948 units/g-1.1 （95% Ch 1.01-2.9, P = 0.04）. Conclusions In our study, the independent predictors of postoperative atrial fibrillation after CABG in elderly patients were left atrium dimension and the increased postoperative concentration of IL-6, IL-8 and superoxide dismutase.

关键词： Antioxidant Atrial fibrillation coronary artery bypass graft Interleukins Troponin

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Long-term outcome of native artery versus bypass graft intervention in prior coronary artery bypass graft patients with ST-segment elevation myocardial infarction

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Chinese Medical Journal 2013年第12期126卷 2281-2285页

作者： LIU Wei LIU Yu-yang Venkata K. Mukku SHI Dong-mei LU Shu-zheng ZHOU Yu-jie Department of Cardiology Beijing An Zhen Hospital Capital Medical University Beijing 100029 China

Background Patients with prior coronary artery bypass graft （CABG） have a poor outcome after acute myocardial infarction （AMI）.Little is known about the treatment strategy and outcome of percutaneous coronary intervention （PCI） in these *** purpose of this study was to investigate the impact of graft versus native artery PCI on the outcomes of prior CABG patients with *** Between September 2005 and October 2011,a total of 140 consecutive patients with previous CABG undergoing PCI for the treatment of AMI were ***/procedural characteristics and long-term clinical outcomes were compared between graft and native artery PCI *** The mean time interval to prior CABG was （5.6±4.2） *** patients received graft PCI,success rate being 90%.One hundred and ten patients received native artery PCI,success rate being 90.7% （P 〉0.05）.There were no significant differences in the basic characteristics between the two *** patients received drug eluting stents （DESs）.Three patients died during hospitalization in the graft-PCI group （10% *** PCI 0,P 〈0.05）.After a median followup of two years,major adverse cardiac events （MACE）（myocardial infarction,target vessel revascularization,total death） were 20% with no significant difference between the two *** regression analysis showed that both diabetes mellitus （DM,HR 3.57,95% CI 1.03-5.75,P 〈0.05） and primary PCI （HR 5.932,95% Cl 1.91-18.4,P 〈0.05） were independent predictors of *** More patients with prior CABG underwent native artery PCI for *** to culprit graft vessels had higher in-hospital *** and primary PCI,but not graft PCI,were predictors for adverse long-term outcome.

关键词： coronary artery bypass graft percutaneous coronary intervention acute myocardial infarction

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Preoperative Intra-Aortic Balloon Counterpulsation in coronary artery bypass graft Patients with Severe Left Ventricular Dysfunction

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World Journal of Cardiovascular Diseases 2016年第10期6卷 321-328页

作者： Andrea Cristina Oliveira Freitas Danilo B. Gurian Wladmir F. Saporito Leandro N. Machado Louise Horiuti Adilson C. Pires Rua Dr. Henrique Calderazzo Sao Paulo Brazil

Background: The intra-aortic balloon pumping (IABP) is the most used ventricular mechanical assist device. In recent years, the preoperative use in patients with severe ventricular dysfunction presents itself as a great benefic strategy to the postoperative recovery. This paper aim is to evaluate the IABP post-operative benefit in patients with severe ventricular dysfunction. Methods: From January 2011 to March 2016, 125 patients underwent a coronary artery bypass graft (CABG) with cardiopulmonary bypass and preoperative IABP in Teaching Hospital of the ABC Medical School and Hospital Estadual Mario Covas. The inclusion criteria were the presence of severe ischemic cardiomyopathy with left ventricular ejection fraction (LVEF) less than or equal to 40%, estimated by Doppler echocardiography using the Simpson method. The preoperative LVEF was 30.25% ± 8.53% and the diastolic diameter of the left ventricle (LVDD) 67.75 ± 16.37 mm. IABP was installed approximately 15 hours before the surgery. Results: The patients required the IABP for 2.4 ± 1.58 days, and vasoactive drugs, 4.8 ± 2.12 days. We performed 3.2 ± 1.9 grafts per patient and the total length of stay was 07 ± 5.52 days. Cardiopulmonary bypass time was 67 ± 10.95 minutes and anoxia time, 46.4 ± 10.06 minutes. Twelve patients (9.6%) had pneumonia and four (3.2%), atrial fibrillation. We observed a LVDD reduction to 63 ± 16.26 (p = 0.068) and LVEF enhancement to 36.50 ± 16.86 (p = 0.144). The data were analyzed statistically according to the Wilcoxon test. There were no deaths. Conclusion: The initial experience of the authors with the preoperative IABP in patients with severe left ventricular dysfunction suggests great benefit in post-operative recovery with im-provement of LVEF and reduction of LVDD.

关键词： Intra-Aortic Balloon Pumping Left Ventricular Dysfunction coronary artery bypass graft

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Numerical Simulation of coronary artery bypass graft with an Assistant graft

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Chinese Journal of Biomedical Engineering(English Edition) 2014年第1期23卷 38-46页

作者： WANG Wei WANG Feng Navy Genneral Hospital

The conventional bypass design is to implant a graft on the stenosed host artery allowing blood to flow bypass the stenotic artery. However, restenosis is a challenging problem which finally results in reoperation. The purpose of this paper is to propose a new bypass graft design of coronary artery with an assistant graft for the treatment of coronary artery stenosis. An additional assistant graft was employed in the new design compared with the conventional ETS anastomosis. Numerical simulations were performed by means of finite volume method using computational fluid dynamics(CFD) solver. Results demonstrated that the new anastomoses model provided a more smooth flow at the distal ETS anastomosis without any stagnation point on anastomotic bed and vortex formation in the heel region. Oscillatory shear index(OSI) and time-averaged wall shear stress gradient(TAWSSG) at the artery bed of the distal ETS anastomosis were reduced. The coronary artery bypass graft with an assistant graft is feasible to improve the local hemodynamics and diminish the probability of restenosis in the treatment of coronary artery stenosis.

关键词： computational fluid dynamics coronary artery bypass graft wall shearstress hemodynamics

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Exploration of Syndrome Differentiation Patterns in coronary Heart Disease Patients during Peri-Operative Stage of coronary artery bypass graft

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Chinese Journal of Integrative Medicine 2001年第3期7卷 195-198页

作者：吴焕林阮新民张敏州黄春林邓铁涛 The Heart Center Guangdong Provincial TCM Hospital

Objective: To explore the patterns of Syndrome Differentiation (SD) of coronary heart disease (CHD) patients in peri-operative stage of coronary artery bypass graft (CABG).Methods: One week after operation, thirty-seven CHD patients, who received CABG of internal mammary artery or great saphena vein under conventional general anesthesia with low or middle temperature extracorporeal circulation were differentiated as various syndromes, with the pre- or post-operational EKG, color Doppler echocardiography were done during and after operation. The hemodynamic parameters were ***: In the CHD patients, 64.9% were differentiated as Qi-Yin deficiency, 67.6% were complicated with phlegm syndrome and 62.2% with blood stasis, suggesting that Qi-deficiency, phlegm and stasis are the basic pathogenetic factors in patients with CABG. Moreover, the peri-operative syndrome was correlated with the condition of coronary artery lesion, heart and lung functions before operation, and the extracorporeal circulation time during the ***: TCM SD conducting in peri-operative stage might be useful in exploring the patterns of syndrome alteration which provided a basis for preventing peri-operative complications and elevating success rate of operation.

关键词： coronary heart disease coronary artery bypass graft peri-operative stage Syndrome Differentiation of TCM Qi-Yang deficiency Yin deficiency Phlegm Syndrome blood stasis

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Long term outcomes of drug-eluting stent versus coronary artery bypass grafting for left main coronary artery disease： a meta-analysis

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Journal of Geriatric Cardiology 2018年第2期15卷 162-172页

作者： Kong-Yong CUI Shu-Zheng LYU Xian-Tao SONG Fei YUAN Feng XU Min ZHANG Ming-Duo ZHANG Wei WANG Dong-Feng ZHANG Jing DAI Jin-Fan TIAN Yun-Lu WANG Department of Cardiology Beijing Anzhen Hospital Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing China Department of Anesthesiology Beijing Chaoyang Hospital Capital Medical University Beijing China

Background It is still controversial whether percutaneous coronary intervention with drug-eluting stent （DES） is safe and effective compared to coronary artery bypass graft surgery （CABG） for unprotected left main coronary artery （ULMCA） disease at long-term follow up （≥3 years）. Methods Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library up to December 6, 2016. The primary endpoint was a composite of death, myocardial infarction （MI） or stroke during the longest follow-up. Death, cardiac death, MI, stroke and repeat revascularization were the secondary outcomes. Results Four randomized controlled trials and twelve adjusted observational studies involving 14,130 patients were included. DES was comparable to CABG regarding the occurrence of the primary endpoint （FIR = 0.94, 95% CI： 0.86-1.03）. Besides, DES was significantly associated with higher incidence of MI （HR = 1.56, 95% CI： 1.09-2.22） and repeat revascularization （HR = 3.09, 95% CI： 2.33-4.10） compared with CABG, while no difference was found between the two strategies regard as the rate of death, cardiac death and stroke. Furthermore, DES can reduce the risk of the composite endpoint of death, MI or stroke （HR = 0.80, 95% CI： 0.67-0.95） for ULMCA lesions with SYNTAX score ≤32. Conclusions Although with higher risk of repeat revascularization, PCI with DES appears to be as safe as CABG for ULMCA disease at long-term follow up. In addition, treatment with DES could be an alternative interventional strategy to CABG for ULMCA lesions with low to intermediate anatomic complexity.

关键词： coronary artery bypass graft Dmg-eluting stent Long term Unprotected left main coronary disease

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A huge thrombosed aneurysm of a saphenous vein graft leading to compression of cardiac structures： role of multimodality imaging

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Journal of Geriatric Cardiology 2017年第8期14卷 536-537页

作者： Byung Gyu Kim In-Cheol Kim Seok-Min Kang Young-Nam Youn Division of Cardiology Department of Internal Medicine Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul South Korea Division of Cardiology Department of Internal Medicine Seoul Paik Hospital Inje University College of Medicine Seoul South Korea Division of Cardiology Department of Internal Medicine Keimyung University Dongsan Medical Center Daegu South Korea Department of Thoracic and Cardiovascular Surgery Severance Cardiovascular Hospital Yonsei University College of Medicine Seoul South Korea

Aneurysmal change of saphenous vein grafts （SVG） is a rare condition that predominantly develops 10-20 years after coronary artery bypass graft （CABG）. Natural course includes mechanical complications due to mass effect, myocardial infarction and aneurysmal rupture. Aneurysmectomy can be considered when it induces such complications. We demonstrate complete set of diagnosis, treatment and post-operative imaging of a huge SVG aneurysm that was successfully treated with surgical resection.

关键词： coronary artery bypass graft Multimodality imaging Saphenous vein graft aneurysm

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Long-Term Outcomes after coronary artery bypass grafting with Risk Stratification

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World Journal of Cardiovascular Diseases 2023年第8期13卷 493-510页

作者： Ayman R. Abdelrehim Ibraheem H. Al Harbi Hasan I. Sandogji Faisal A. Alnasser Mohammad Nizam S. H. Uddin Fatma A. Taha Fareed A. Alnozaha Fath A. Alabsi Shakir Ahmed Waheed M. Fouda Amir A. El Said Tousif Khan Ahmed M. Shabaan Cardiac Surgery Department Madinah Cardiac Center Madinah Saudi Arabia Cardiothoracic Surgery Department Faculty of Medicine Menoufia University Minufya Egypt Cardiology Department Madinah Cardiac Center Madinah Saudi Arabia Cardiac Anesthesia Department Madinah Cardiac Center Madinah Saudi Arabia Cardiology Department Faculty of Medicine Tanta University Tanta Egypt Cardiothoracic Surgery Department Faculty of Medicine Suez Canal University Ismailia Egypt

Background: Risk stratification of long-term outcomes for patients undergoing coronary artery bypass grafting has enormous potential clinical importance. Aim: To develop risk stratification models for predicting long-term outcomes following coronary artery bypass graft (CABG) surgery. Methods: We retrospectively revised the electronic medical records of 2330 patients who underwent adult Cardiac surgery between August 2016 and December 2022 at Madinah Cardiac Center, Saudi Arabia. Three hundred patients fulfilled the eligibility criteria of CABG operations with a complete follow-up period of at least 24 months, and data reporting. The collected data included patient demographics, comorbidities, laboratory data, pharmacotherapy, echocardiographic parameters, procedural details, postoperative data, in-hospital outcomes, and follow-up data. Our follow-up was depending on the clinical status (NYHA class), chest pain recurrence, medication dependence and echo follow-up. A univariate analysis was performed between each patient risk factor and the long-term outcome to determine the preoperative, operative, and postoperative factors significantly associated with each long-term outcome. Then a multivariable logistic regression analysis was performed with a stepwise, forward selection procedure. Significant (p bypass time (AOR: 1.029, p = 0.003), and the dur

关键词： coronary artery bypass graft Long-Term Mortality Risk Prediction Model Risk Stratification

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