PSI - Issue 40

V. Mironov et al. / Procedia Structural Integrity 40 (2022) 296–306 V. Mironov at al. / Structural Integrity Procedia 00 (2022) 000 – 000

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without any reaction to stimuli in tests were shown to have the highest risk of death and complications Ewing at al. (1978). RCG and HRV analyses were performed in all 123 pts by specialized diagnostics in the initial lying position with the use of 4 stimulant tests for defining predictors of the complications during surgery. Such predictors were defined. Initially, additional RCG-symptoms characteristic of stable and unstable angina pectoris Mironov (2002), Mironova at al. (2009), Ewing at al. (1978) were defined for the coronary artery disease (CAD) before CABGS. In a number of patients, HRV stabilization was registered during ischemic episodes of the angina pectoris. It was related to the hibernation of pacemaker cells due to the circulation breach induced by a non-stable atherosclerotic plaque deriving high activity of Endothelin-1 Mironov (2002), Mironova at al. (2000, 2009).

Table 3. Average HRV indices during stages of the CABGS (n-123).

Stages of CABGS in M  seconds (s) and %

RR, s average of all RR intervals

SDNN, s Standard deviation of all normal intervals

VLF, % spectral share of humoral metabolic HRV waves

LF, % spectral share of sympathetic HRV waves

HF, % spectral share of parasym pathetic HRV waves

σl, s average quadratic value of humoral metabolic HRV waves

σm , s average quadratic value of sympathetic HRV waves

σs , s average quadratic value of

parasympat hetic waves

Premadication and intubation narcosis

0. 783± 0.03 0. 653± 0.024

0. 003± 0.001 0. 003± 0.001

0. 003± 0.001 0. 003± 0.001

0. 0013± 0.001 0. 0015± 0.001

0. 0015± 0.001 0. 0013± 0.001

72. 2± 18.4% 84. 2± 11.2%

12. 8± 4.23%

15. 0± 3.5% 8. 4± 2.82%

Cannulation. vessels, ventr. arrhythmias

7. 4± 3.4%

Introduction of cardioplegic solution, AF, ventr. arrhythmias, asystole Connection to an apparatus of artificial circulation (AAC)

0. 810± 0.033

0. 004± 0.001

0. 002± 0.002

0. 004± 0.001

0. 001± 0.001

91. 2± 7.2%

6. 4± 2.33%

2. 4± 1.87%

0. 580± 0.087

0. 002± 0.001

0. 002± 0.002

0. 002± 0.001

0. 001± 0.001

90. 2± 10.8%

6. 8± 3.2%

3. 0± 1.9%

Removing clips, disabling from AAC Heart activity restoration

0. 564± 0.034

0. 003± 0.001

0. 003± 0.001

0. 002± 0.001

0. 001± 0.001

88. 6± 12.4%

5. 4± 1.9%

5. 0± 2.1%

0. 680± 0.110

0. 006± 0.002

0. 006± 0.002

0. 002± 0.001

0. 001± 0.001

87. 2± 7.12%

5. 0± 2.1%

7. 8± 3.4%

The cardiopulmonary pump artificial circulation open heart CABGS was performed. HRV was recorded during CABGS by named specialized APC for high- resolution of ECS discretization 1000± 3 Hz with a monitor record (Russian Patent No. 71530, Certificate of RusAPO No 950230). RCG was made with the use of software for RCG research; HRV analyses were made out in Time- and Frequency-Domains with Fast Fourier's transformation and Parsen's and Hamming’s spectral windows. Basic HRV indices were considered, namely the RR-average value of all the intrasystole intervals, their standard deviation (SDNN), mean square deviations of the humoral- metabolic (σ l ), sympathetic (σ m ) and parasympathetic (σ s ) amplitudes of HRV-fluctuations. Also, their spectral shares (VLF%, LF%, and HF%) were valued for the correlation of the ratio influence of regulative factors of pacemaker activity in SN. The monitor rhythmocardiogram record (Rcg) was remotely transferred to neurocardiology laboratory for the immediate analysis and recommendations. HRV registration was carried out to cardiac arrest and passage of the blood circulation to apparatus of artificial circulation. HRV record stopped at the moments of electric knife work because of non-clinical arrhythmia breaches. At the same time, with RCG record in real current time, the electrocardiogram (ECG) was registered. There may be seven fragments of ECG and RCG records for evaluation. After every 300 RR-intervals, auto- and spectral analyses were automatically registered, shown on the screen, saved