Cerebrovascular complications of patients with coronary heart disease who underwent coronary bypass surgery (five-year follow-up)

Authors: Syrova I.D., Lozhkin I.S., Trubnikova O.A., Artamonova A.I., Portnov Yu.M., Semenov S.E., Maleva O.V., Kovalenko A.V., Garganeeva N.P.

Company: 1 Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, 650002, Russian Federation
2 Siberian State Medical University, 634050, Tomsk, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2020-14-4-313-323

For citation: Syrova I.D., Lozhkin I.S., Trubnikova O.A., Artamonova A.I., Portnov Yu.M., Semenov S.E., Maleva O.V., Kovalenko A.V., Garganeeva N.P. Cerebrovascular complications of patients with coronary heart disease who underwent coronary bypass surgery (five-year follow-up). Creative Cardiology. 2020; 14 (4): 313–23 (in Russ.). DOI: 10.24022/1997-3187-2020-14-4-313-323

Received / Accepted:  01.09.2020 / 10.09.2020

Keywords: cerebrovascular complications coronary heart disease coronary bypass surgery five-year follow-up

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Abstract

Objective. Evaluation of the incidence of cerebrovascular complications, neurological status and state of the brain according to multispiral computed tomography (MSCT) in patients in the long-term period of coronary artery bypass grafting (CABG).

Material and methods. Before the CABG, we examined 175 male patients, whose average age was 57.8 ± 5.6 years. 3–5 days before and 5.9 ± 0.8 years after the operation, all patients were examined by a neurologist, cardiologist, neuropsychological testing and brain MSCT were performed.

Results. After five years, the clinic for angina pectoris was absent in 76.3% of patients, the functional class (FC) of chronic heart failure (CHF) III decreased from 21.5% to 2.2%, p = 0.0001. Acute cerebrovascular accident (ACVA) developed in 6.0% of patients. Dementia with the definition of a disability group was detected in 1.2% of patients. In neurological status, the incidence of vestibulopathy syndrome increased from 24.4% to 35.6%, p = 0.04, the incidence of asthenic syndrome decreased from 56.0% to 30.4%, p = 0.00001; revealed paresis, sensorimotor aphasia. According to MSCT of the brain, the expansion of the third ventricle occurred from 7.1 ± 2.0 mm to 8.6 ± 2.4 mm, p=0.04; an increase in the number of patients with cysts and areas of gliosis by 18.6%, with leukoaraiosis by 47.4%. Deterioration of individual indicators in cognitive tests was detected in 43% of patients, more often cognitive decline was detected in tests ssessing neurodynamics and memory.

Conclusion. An important outcome of the CABG five ears after the operation was the absence of a clinical picture of angina pectoris and a decrease in the FC of CHF in most patients. However, a number of patients developed stroke, cognitive decline and dementia. Deterioration of neurological and cognitive status occurred against the background of deterioration of the state of the brain according to MSCT data in the form of expansion of the cavity system, progression of leukoaraiosis, and an increase in the number of patients with cysts and gliosis.

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About Authors

  • Irina D. Syrova, Cand. Med. Sc., Researcher, ORCID
  • Igor’ S. Lozhkin, Postgraduate, ORCID
  • Ol’ga A. Trubnikova, Dr. Med. Sc., Head of Laboratory, ORCID
  • Anna I. Artamonova, Researcher, ORCID
  • Yuriy M. Portnov, Cand. Med. Sc., Researcher, ORCID
  • Stanislav E. Semenov, Dr. Med. Sc., Leading Researcher, ORCID
  • Ol’ga V. Maleva, Cand. Med. Sc., Researcher, ORCID
  • Ol’ga V. Maleva, Cand. Med. Sc., Researcher, ORCID
  • Natal’ya P. Garganeeva, Dr. Med. Sc., Professor, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery