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The aim of the study was to detect the associations between heart rate variability (HRV) and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The study was performed in Kaunas, Lithuania, during 2008–2012. We used data of 220 patients. HRV was assessed by a 5-minute electrocardiogram. The data were collected at 1.5 months, 1 year, and 2 years after the surgery (495 measurements). A negative association of standard deviation of beat-to-beat interval (SDNN), very low frequency (VLF), low frequency, and high frequency (HF) powers with a decrease in air temperature (T) during a 3-day period in the range of T < 1°C wind speed >2.75 knots 2 days before, and the daily North Atlantic Oscillation indices were observed. The effect of wind speed on SDNN and VLF power was stronger in males. Two days after relative humidity >89%, a lower mean VLF and higher HF in normalized units were found; in females, this effect was stronger 1.5 months after the surgery. Among patients after open-heart surgery, the HRV variables may be related to specific weather changes and the effect of weather was different for males and females and at different times after the surgery. [ABSTRACT FROM AUTHOR]

Patients with cardiovascular disease have depression more often than the general population does. The aim of the study was to detect the associations between the psychological state and weather variables in patients who underwent coronary artery bypass grafting or valve surgery. The prospective study was performed during 2008–2012 in Kaunas, Lithuania. The psychological state of 233 patients was assessed by using the Symptom Checklist-90-Revised instrument. The assessment was carried out at 1.5 months, 1 year, and 2 years after the surgery. A sample of 531 measurements of psychological states was used. To investigate the relationships between psychological scores and daily weather variables, a mixed linear model was used adjusting for sex, the type of surgery, age, the marital status, the presence of arterial hypertension, diabetes, major depressive disorders, dysthymic disorders, agoraphobia, smoking before surgery, and myocardial infarction in the anamnesis. The mean somatisation score and air temperature on the second day prior to the survey were found to have a negative correlation in the multivariate model. Lower mean scores of anxiety and depression were linked to hotter days (air temperature >16.25°C on the second day) that did not occur in July or August. During colder days (air temperature <0.35°C), a higher mean score of anxiety and phobic anxiety was observed. A higher mean score of somatizations, depression, and anxiety was seen on the second day after the day with wind speed ≤2.85 kt and on the day after the day with relative humidity <66%. Both a decrease and an increase in daily atmospheric pressure were associated with a higher depression score. Our results confirm that among patients after open heart surgery, psychosomatic complaints are related to some weather changes. The obtained results can help to determine the complexity of weather patterns linked to poorer psychological health. [ABSTRACT FROM AUTHOR]

Objectives. To assess preoperative depression in middle-aged men undergoing coronary artery bypass graft surgery (CABG) and to determine if depression is related to perioperative outcomes. Design. One hundred and nine middle-aged male patients were randomly selected and assessed for depression one day before CABG using the Symptom Checklist-90 Revised (SCL-90R). Perioperative outcomes were: (1) postoperative length of hospital stay, (2) the presence of any early complications (at intensive care unit), and (3) the presence of any late complications (at cardiac surgery unit). Results. Twenty-five (23%) patients had a high level of depression. Preoperative depression scores significantly predicted postoperative length of hospital stay (p<0.001) and the incidence of late perioperative complications (p<0.05) independently from biomedical and sociodemographic factors. Each increase in depression T score increased the odds of occurrence of late complications by 10% (p=0.018, CI 95% 1.02-1.19). Conclusions. Depression is common in middle-aged men undergoing CABG and is an independent predictor of postoperative length of hospital stay and late perioperative complications. [ABSTRACT FROM AUTHOR]

Objectives. Annuloplasty is the most common surgical procedure for ischemic mitral regurgitation (MR) that improves symptoms but is also subjected to high incidence of recurrent MR. One of the reasons of recurrent MR could be further left ventricular (LV) remodeling. Design. The study population consisted of 195 patients with ischemic MR. Mitral valve repair and bypass surgery was performed between 2000 and 2006. Results. LV end diastolic diameter (LVEDD) increased in 30.3% of patients in one year following mitral repair. Multivariate ANOVA analysis revealed that if LVEDD index (LVEDDi) before surgery is less than 25 mm/m2, the probability for LVEDDi to diminish or to stay at the same range is 84.6% higher, than in the case of preoperative LVEDDi ≥25 mm/m2 and other predictive variables. Conclusions. Predictive factors for further LV remodeling after ischemic mitral repair 1 year after surgery are preoperative LVEDDi, preoperative LV end systolic diameter index, tricuspid regurgitation grade before surgery, and early postoperative MR grade. [ABSTRACT FROM AUTHOR]

Aim. The aim of this prospective randomized study was to evaluate the impact of long-term aerobic exercise training on respiratory function, left ventricular systolic function and remodeling in patients with coronary heart disease and ischemic heart failure after successful angioplasty. Design. Patients (n=185) have undergone Doppler echocardiography and ergospirometry. Ninety-five patients practiced 6 month-term aerobic exercise training, less by 10% to their anaerobic threshold. Ninety patients were studied as controls. They were given only drug treatment without training. Measurements were repeated after 6 and 12 months. Results. Training group patients after 6 months showed significant (p<0.05) improvement in exercise capacity, oxygen consumption and ventilating equivalents. The Doppler echocardiographic findings revealed significant (p<0.05) improvement in ejection fraction, left ventricular and atria morphometric data. Improved ergospirometric and echocardiographic data were established after 12 months, too. Conclusions. Long-term aerobic exercise training is an effective and workable measure improving respiratory efficiency, left ventricular systolic function, attenuating negative remodeling and stopping further progression in patients with coronary heart disease and chronic heart failure after successful angioplasty. [ABSTRACT FROM AUTHOR]

Objective . To define the mechanisms of ischemic mitral regurgitation (MR) and its correlation with left ventricular (LV) function prior to and 1 year following mitral valve (MV) repair. Design . Fifty-three patients (pts) underwent echocardiographic evaluation of the MR mechanism according to Carpentier's classification; quantification of MR and LV function. Results . Forty-one, 5% of pts had Type I (annulus dilation), 20, 5% had Type II (commissural prolapse) and 38% had Type IIIb MR (predominant posterior leaflet restriction). Preoperative LV function was slightly better preserved in pts with Type II and IIIb MR. Despite similar MV repair efficiency intraoperatively, after 1 year Type I MR progressed vs the remaining types. LV function, including dimensions, ejection fraction and pulmonary artery pressure had a tendency to worsen in pts with Type I and markedly improved in Type II and IIIb MR. Conclusions . Ischemic MR of Type I is associated with more marked LV dysfunction preoperatively, its further deterioration and MR progression after MV repair. Type II and IIIb MR correlates with better preserved LV function preoperatively and its incremental improvement late after surgery. [ABSTRACT FROM AUTHOR]