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Post a Comment Clinical and electrophysiological characteristics of psychovegetative syndrome during rehabilitation after coronary bypass graft
- Authors: Mirzoev R.A.1, Malchikova S.V.1, Isaeva O.V.1, Matantsev A.G.1, Chudinovskikh T.I.1, Kolupaev A.N.1, Sherman M.A.1
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Affiliations:
- Kirov State Medical University
- Issue: Vol 39, No 3 (2022)
- Pages: 11-24
- Section: Original studies
- URL: https://journals.rcsi.science/PMJ/article/view/104650
- DOI: https://doi.org/10.17816/pmj39311-24
- ID: 104650
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Abstract
Objective. To investigate the impact of anxiety in development of psychovegetative syndrome in patients after operative myocardial revascularization, to describe the nature and direction of resulting autonomic dysfunction and to study the effect of treatment with anti-anxiety therapy for this condition.
Materials and methods. 54 patients aged 45–75 (36 – the main group, 18 – the comparison group), on average 11–12 days after the coronary artery bypass graft (CABG) and during the process of early and late postoperative rehabilitation were investigated. A score assessment of the psychological and autonomic spheres, and sleep quality was analyzed. Indicators of vegetative tone and vegetative regulation were assessed, in particular, temporal and spectral indicators of heart rate variability. In addition to basic therapy for ischemic heart disease (IHD), the patients of the main group received therapy with vegetative corrector.
Results. In most cases, in the early postoperative period after CABG, moderate anxiety disorders and sleep disturbance were registered in combination with autonomic dysregulation with sympathetic influences prevailing. Addition of psychotropic therapy to the basic therapy of IHD patients in the main group allowed for 10–14 days to significantly reduce the level of anxiety, improve sleep quality and correct the existing autonomic disorders with a tendency to further regression in the late postoperative period.
Conclusions. This study found that patients with an increased level of anxiety after CABG are characterized by the formation of a psychovegetative syndrome with predominance of sympathetic activity. The use of anxiolytic therapy can reduce the severity of anxiety and autonomic dysfunction, which can probably become an additional factor contributing to successful rehabilitation of patients after CABG in the early and late postoperative periods and prevention of IHD progression.
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##article.viewOnOriginalSite##About the authors
Ruslan A. Mirzoev
Kirov State Medical University
Email: RuslanaMirzoeva@yandex.ru
ORCID iD: 0000-0003-4344-5627
neurologist of KSMU clinic, postgraduate student of Department of Neurology, Neurosurgery and Neurorehabilitation
Russian Federation, KirovS. V. Malchikova
Kirov State Medical University
Email: ruslanamirzoeva@yandex.ru
MD, PhD, Professor of Department of Hospital Therapy, Head of Therapeutics Unit of KSMU clinic
Russian Federation, KirovO. V. Isaeva
Kirov State Medical University
Email: ruslanamirzoeva@yandex.ru
cardiologist of KSMU clinic
Russian Federation, KirovA. G. Matantsev
Kirov State Medical University
Email: ruslanamirzoeva@yandex.ru
cardiologist of KSMU clinic
Russian Federation, KirovT. I. Chudinovskikh
Kirov State Medical University
Email: ruslanamirzoeva@yandex.ru
Candidate of Medical Sciences, Assistant of Department of Hospital Therapy, therapeutist of KSMU clinic
Russian Federation, KirovA. N. Kolupaev
Kirov State Medical University
Email: ruslanamirzoeva@yandex.ru
doctor of functional diagnostics of KSMU clinic
Russian Federation, KirovM. A. Sherman
Kirov State Medical University
Author for correspondence.
Email: ruslanamirzoeva@yandex.ru
MD, PhD, Associate Professor, Head of Department of Neurology, Neurosurgery and Neurorehabilitation
Russian Federation, KirovReferences
- Piepoli M.F., Hoes A.W., Agewall S., Albus C., Brotons C., Catapano A.L., Cooney M-T., Corra U., Cosyns B., Deaton C., Graham I., Hall MS., Hobbs R., Løchen M-L., Löllgen H., Marques-Vidal P., Perk J., Presscott E., Redon J., Richter D.J., Sattar N., Smulders Y., Tiberi M., Bart van der Worp N.S.H., van Dis I., Verschuren W.M.M. European Guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical in Clinical Practice. European Heart Journal 2016; 252: 207–274.
- Beljalov F.I. Depression, anxiety and stress in patients with ischemic heart disease. Terapevticheskii arkhiv. 2017; 8: 104–109 (in Russian).
- Cristian D., Markus K., Joanna M. Current status of brain imaging in anxiety disorders. Curr Opin Psychiatry 2009; 22 (1): 96–110.
- Ibatov A.D. The influence of anxiety disorders on the course of coronary heart disease. Russian Medical Journal 2007; 20: 1443–1449 (in Russian).
- Shvalev V.N. Pathological changes in the sympathetic division of the autonomic nervous system and cardiovascular pathology. Arkhiv patologii 1999; 3: 50–52 (in Russian).
- Tully P.J., Baker R.A. Depression, anxiety, and cardiac morbidity outcomes after coronary artery bypass surgery: a contemporary and practical review. Journal of Geriatric Cardiology 2012; 9: 197–208.
- Kubzansky L.D., Kawachi I. Going to the heart of the matter: do negative emotions cause coronary heart disease? J. Psychosom. Res. 2000; 48 (4–5): 323–337.
- Mkrtchyan V.N., Bendeliani N.G., Kozhokova L.Z. Anxiety and depression in pathogenesis of atherosclerosis and ishemic heart disease. Byulleten' NTSSSKH im. A.N. Bakuleva RAMN 2014; 15 (2): 10-16 (in Russian).
- Slobozhaninova E.V., Savinykh E.A., Chepurnykh A.Ya., Shamsutdinova R.A. Coronary artery bypass graft in the treatment of coronary heart disease. Medical Newsletter of Vyatka 2020; 3: 81–84 (in Russian).
- Verbitskiy E.V. Anxiety and sleep in experiment and clinic. S.S. Korsakov Journal of Neurology and Psychiatry 2017; 117 (4): 12–18 (in Russian).
- Tobaldini E. Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence. Nat. Rev. Cardiol. 2019; 16 (4): 213–224.
- Sabirovа E.Y., Chicherinа E.N., Epshtein A.M. Coronary artery bypass graft in the treatment of coronary heart disease. Actual state of the question. Medical Newsletter of Vyatka. 2012; 4: 49–54 (in Russian).
- Burlakov A.V., Bocharova M.V. Mental disorders in the preoperative period of coronary artery bypass surgery. Psikhiatriya i psikhofarmakoterapiya. 2003; 5 (6): 12–15 (in Russian).
- Mukhtarenko S.Yu., Murataliev T.M., Radzhapova Z.T., Neklyudova Y.N. Affective disorders and quality of life in patients with coronary heart disease according to psychometric tests data. Klinicist 2018; 12 (2): 28–36 (in Russian).
- Minakova I.V., Minakova N.E., Dubachev A.A. Indicators of the spectral analysis and traditional parameters of variability of the cardiac rhythm at patients after reconstructive cardiointetvention. Journal of New Medical Technologies 2010; 17 (2): 133–136 (in Russian).
- Kupper N., Denollet J., Widdershoven J.W., Kop W.J. Cardiovascular reactivity to mental stress and mortality in patients with heart failure. JACC Heart Fail 2015; 3 (5): 373–382.
- Bokeriya L.A., Aronov D.M., Barbarash O.L., Bubnova M.G., Knyazeva T.A., Lyamina N.P., Malikov V.E., Novikova N.K., Petrunina V.E., Arzumanyan M.A., Sumin A.N., Chumakova G.A., Akchurin R.S., Alishbaya M.M., Barbarash L.S., Bojcov S.A., Boldueva S.A., Buziashvili Yu.I., Galyavich A.S., Glezer M.G., Gordeev M.L., Zajcev V.P., Ivanova G.E., Ioseliani D.G., Karpov R.S., Mazaev V.P., Martynov A.I., Merzlyakov V.Yu., Misyura O.F., Perepech N.B., Repin A.N., Ruda M.Ya., Sigaev I.Yu., Smulevich A.B., Syrkin A.L., Chazov E.I., Chazova I.E., Shlyahto E.V., Yakushin S.S. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics 2016; 7 (3–4): 5–71 (in Russian).
- Veyn A.M. Diseases of the autonomic nervous system: Rukovodstvo dlya vrachei. M.: Meditsina 1991: 624 (in Russian).
- Khodyrev G.N., Khlybova S.V., Tsirkin V.I., Dmitrieva S.L. Methodological aspects of analysis of temporal and spectral parameters of heart rate variability (review). Medical Newsletter of Vyatka 2011; 3-4: 60–71 (in Russian).
- Kiselev A.R., Vulf K.A., Shvarts V.A., Karavaev A.S., Borovkova E.I., Bockeria O.L. Comparative evaluation of autonomic regulation of circulation in patients undergone coronary artery bypass grafting or correction of acquired valvular heart disease. Saratov J. Med. Sci. Res. 2018; 14 (1): 45–9 (in Russian).
- Beinart R., Zhang Y., João A.C,. Lima J.A., Bluemke D.A., Soliman E.Z., Heckbert S.R., Post W.S., Guallar E., Nazarian S. The QT interval is associated with incident cardiovascular events: the MESA study. J. Am. Coll. Cardiol. 2014; 64 (20): 2111–2119.
- Makarov LM. Features of using the analysis of heart rate variability in patients with heart disease. Fiziologiya cheloveka 2002; 28 (3): 65–68 (in Russian).
- Kiseleva, I.V., Agapov A.A., Akchurin R.S., Sobolev A.V., Ryabykina, G.V., Chikovani S.I. Heart rate variability in patients with ischemic heart disease before and after coronary artery bypass graft. Journal of arrhythmology 2003; 32: 42–43 (in Russian).
- Oynotkinova O.Sh., Spasskiy A.A., Baranov A.P., Poddubskaya E.A., Shklovskii B.L., Leksina N.Yu. Psychotropic and antioxidant therapy in the rehabilitation of cardiac patients. Arhiv vnutrennej mediciny 2013; 2: 65–70 (in Russian).
- Bakumov P.A., Evseev A.V. The using of tranquilizers in therapeutic practice. Lekarstvennyj vestnik. 2004; 2: 9–17 (in Russian).
- Davydov A.T., Petrova N.N., Litvincev S.V., Vutko D.Yu., Strel'nikov A.A. Modern antidepressants, their role and place in psychiatric and general medical practice. Reviews On Clinical Pharmacology and Drug Therapy 2007; 1: 49–62 (in Russian).
- Ljubimov A.V., Karchaa A.R. Application of Teraligen® in treatment of cerebral vegetative dysfunction. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Serija: Medicina. Farmacija 2012; (4): 20–25 (in Russian).
- Jones P.B, Buckley P.F. Schizophrenia: Klinicheskoe rukovodstvo. Moscow: MEDpress-inform 2008; 192 (in Russian).
- Roohafza H., Sadeghi M., Khani A., Andalib E., Alikhasi H., Rafiei M. Psychological state in patients undergoing coronary artery bypass grafting surgery or percutaneous coronary intervention and their spouses. Int. J. Nurs. Pracl. 2015; 21 (2): 214–220.
- Açıkel M. Evaluation of Depression and Anxiety in Coronary Artery Bypass Surgery Patients: A Prospective Clinical Study. Braz. J. Cardio-vasc. Surg. 2019; 34 (4): 389–395.
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