Changes in mean arterial pressure and heart rate in patients with coronary heart disease during coronary bypass surgery under artificial circulation in the presence of polymorphisms as potential factors of hemodynamic disorders

Objective. To evaluate the possibility of correcting hemodynamic disturbances in patients with coronary heart disease during coronary artery bypass grafting under artificial circulation using extracorporeal autohemomagnetotherapy in the presence of polymorphisms of the angiotensin-1 receptor (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn), endothelial oxide synthase genes nitrogen (NOS3 C786T) as potential factors of hemodynamic disorders.

Materials and methods. Initially, all patients were divided into two groups. Group 1 (60 patients) included standard anesthetic care for coronary artery bypass grafting under cardiopulmonary bypass without the use of extracorporeal autohemomagnetic therapy (EAHMT). Group 2 (63 patients) included standard anesthesia for coronary artery bypass surgery under cardiopulmonary bypass with the use of EAHMT. Indicators of mean arterial pressure (MAP), heart rate (HR) and relative data indicators were assessed. For each patient, the relative change in MAP and HR was calculated individually. Next, using Statistica 10 software (Statsoft Inc., USA), a descriptive analysis of the obtained data was carried out (Me [25 %; 75 %]). The significance of the results was assessed by the method of dependent characteristics using the nonparametric Wilcoxon test. When comparing independent groups with a non-normal distribution of values of one or two quantitative characteristics, a nonparametric method was used – the Mann – Whitney U test.

All patients of both groups underwent intraoperative venous blood sampling from a central venous catheter. Next, by polymerase chain reaction (PCR) using a Rotor apparatus Gene Q 5 plex HRM (QIAGEN, Germany) carried out the study genotypes polymorphisms of the angiotensin-1 receptor genes (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn), endothelial nitric oxide synthase (NOS3 C786T), with further processing of the results obtained (Pearson Chi-square, odds ratio, Akaike information criterion, Hardy – Weinberg equilibrium) using the online service SNPStats.

Results. The relative change in mean arterial pressure in group 2 was 1.36 %, in group 1 this figure was – 8.99 %. In group 1 and group 2 there was a statistically significant increase in heart rate. The relative change in heart rate in group 1 was 16.55 %, in group 2 this parameter was 20 %. The presence of the C/C genotype of endothelial nitric oxide synthase (NOS3 C786T) may be a factor in correcting changes in MAP and heart rate during the intraoperative period during coronary artery bypass grafting under artificial circulation. The presence of genotypes T/C, T /T of endothelial nitric oxide synthase (NOS3 C786T) may indicate possible difficult-to-control hemodynamic disturbances during these operations. No correlation was found between polymorphisms in the genes of the angiotensin-1 receptor (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn) and hemodynamic status in the intraoperative period.

Conclusion. The EAGMT method in the presence of the C/C genotype of endothelial nitric oxide synthase (NOS3 C786T) can be used when performing CABG under artificial circulation to maintain the stability of invasive hemodynamics and prevent hypotension.

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