Changes of Thyroid Function and Hemodynamic State in Patients Undergoing Coronary Artery Bypass Grafting.
10.4326/jjcvs.27.276
- VernacularTitle:冠動脈バイパス術における甲状腺機能および循環動態の変化
- Author:
Nobuhiko Hayashida
;
Hiroshi Maruyama
;
Eiki Tayama
;
Hiroshi Tomoeda
;
Takeshi Oda
;
Hiroshi Kawano
;
Takemi Kawara
;
Shigeaki Aoyagi
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1998;27(5):276-281
- CountryJapan
- Language:Japanese
-
Abstract:
Perioperative changes in thyroid function and hemodynamic state were studied in 6 hypothyroid patients and 15 euthyroid patients who underwent coronary artery bypass grafting. Serum free T3 and total T3 concentrations declined significantly in hypothyroid patients after the surgery. Serum total T3 concentration decreased significantly also in euthyroid patients, indicating the occurrence of“euthyroid sick syndrome”in this group. Hypothyroid patients resulted in significantly lower left ventricular stroke work index despite greater central venous pressure and pulmonary capillary wedge pressure, and greater requirements of dopamine and dobutamine compared with those in euthyroid patients. The results indicated poorer postoperative cardiac performance in hypothyroid patients. Serum free T3 concentration after cardiopulmonary bypass demonstrated a significant positive correlation with left ventricular stroke work index measured simultaneously. Preoperative serum free T3 concentration showed a significant negative correlation with the postoperative dopamine and dobutamine requirements. Therefore, the results suggest that free T3 has inotropic effects and the concentration of this hormone can be a predictor for a incidence of postoperative low cardiac output. In conclusion, since hypothyroid patients undergoing coronary artery bypass grafting are prone to have low cardiac output status, careful perioperative management, including hormone replacement therapy, is required for the patients.
