The changes and significance of total antioxidative capacity in low cardiac output syndrome

Abstract

Objective To investigate the mutative situation and clinical significance of plasma total antioxidant capacity(T-AOC) in patients with low cardiac output syndrome(LCOS) and non-LCOS after coronary artery bypass graft(CABG). Methods The clinical data of 81 coronary heart disease patients who underwent CABG in Department of Thoracic and Cardiovascular Surgery of the First Affiliated Hospital of Bengbu Medical College from May 2013 to July 2014 were prospectively studied. All 81 patients were treated by CABG, and the central venous blood samples were obtained immediately before surgery, during operation, and at the end of surgery to assess T-AOC by using Diammonium 2, 2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate(ABTS). Patients were divided into groups LCOS and non-LCOS group, according to postoperative condition. The each patient's age, grafts, cardiopulmonary bypass time, aortic crossclamp time, postoperative ICU stay time, ventilation support time, hospitalization time and the mutative situation of T-AOC of before, during and after surgery were recorded. Results LCOS developed in 9 patients(11.11%), and the remaining 72 patients(88.89%) with non-LCOS in these 81 patients. Both LCOS group and non-LCOS group had 1 patient dead. There were no significant differences between LCOS group and non-LCOS group patients with their age and grafts(t values were -0.444, -0.164, respectively, all P values>0.05). Yet cardiopulmonary bypass time, aortic crossclamp time, postoperative ICU stay time, ventilation support time and hospitalization time of the LCOS group were significantly longer than the non-LCOS group, and they were statistically significant(t values were -5.524, -8.120, -9.526, -4.589, -5.787, respectively, all P values 0.05). Compared with the preoperative, two groups of patients' intraoperative and postoperative T-AOC showed a downward trend, the differences were statistically significant(F values were 431.679, 126.474, respectively, all P values<0.05). The intraoperative and postoperative T-AOC of the LCOS group patients was lower than those of non-LCOS, especially. Postoperative to reduce more obvious, the differences were statistically significant(t values were 5.442, 12.942, respectively, all P values<0.01). In addition, ROC area was 0.879. It means that we would have good reliability when we use plasma T-AOC value to surmise whether LCOS would happened, and its sensitivity was 87.5%, specificity was 77.5%. Conclusions The plasma T-AOC levels of patients with coronary heart disease in the process of implementation of CABG will decrease, and plasma T-AOC of patients in postoperative LCOS decreased more significantly. Maybe is related to chemical reperfusion injury or oxidative stress. Routine measurement of the T-AOC during operation can provide information for early assessing and warning of the LCOS development. Key words: Coronary heart disease; Heart surgery; Cardiac output, low; Total antioxidant capacity