Clinical and electrophysiological characteristics of psychovegetative syndrome during rehabilitation after coronary bypass graft

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 4575 (36 the main group, 18 the comparison group), on average 1112 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 1014 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.