Long-Term Neurophysiological Outcomes in Patients Undergoing Coronary Artery Bypass Grafting

Abstract Introduction: This study aims to evaluate late postoperative neurophysiological outcomes in patients after coronary artery bypass grafting (CABG). Methods: Forty-five male patients with stable coronary artery disease aged 45-69 years underwent extended neuropsychological assessment using the software Status PF and electroencephalographical examination 3-5 days before CABG and 5-7 years after CABG. Postoperative decline in cognitive functions was determined by a 20% decrease in the cognitive indicator compared to that at baseline on 20% of the tests included in the Status PF battery. Statistical analysis was performed using the software STATISTICA 10.0. Multiple regression was used to identify demographic, clinical, and electroencephalographical variables associated with adverse cognitive outcomes. Results: Cognitive decline was observed in 54% of the patients in the long-term postoperative period. Five to seven years after CABG, all patients have shown an increase in the theta rhythm power compared to the preoperative values, which is most pronounced in the frontal and temporal areas of the right hemisphere (P=0.04), along with a decrease in the alpha rhythm in the posterior areas of the cortex (P=0.005). Multiple regression has reported that the main predictors of cognitive impairment are slower mean alpha frequency, decreased theta-2 rhythm with eyes closed in the right temporal area, and increased theta-2 rhythm with eyes open in the left temporal area (F(5.39)=8.81; P研究概况与引言：本研究旨在评估冠状动脉旁路移植术（CABG）后患者的术后远期神经生理学结局。 方法：纳入45名年龄45~69岁的稳定型冠状动脉疾病男性患者，分别于术前3~5天及术后5~7年，采用Status PF软件开展扩展神经心理学评估，并实施脑电图检查。以Status PF评估量表中20%的检测项目的认知指标较基线水平下降20%作为术后认知功能减退的判定标准。采用STATISTICA 10.0软件进行统计学分析，通过多元回归分析筛选与不良认知结局相关的人口学、临床及脑电图相关变量。 结果：术后远期随访阶段，54%的患者出现认知功能减退。冠状动脉旁路移植术后5~7年，所有患者的θ节律功率较术前均有所升高，其中以右侧半球额叶与颞叶区域最为显著（P=0.04）；同时大脑皮层后部区域的α节律功率出现下降（P=0.005）。多元回归分析显示，认知损害的主要预测因素包括平均α频率减慢、右侧颞区闭眼时θ-2节律功率降低，以及左侧颞区睁眼时θ-2节律功率升高（F(5.39)=8.81；P