Background

Dietary factors including trace elements contribute to the development of disorders including coronary artery diseases. Whether there are differences in concentrations of trace elements between on-pump and off-pump coronary artery bypass grafting (CABG) surgery remains unclear. The aim of this study was to investigate the differences in the plasma level of four trace elements Cu, Fe, Zn, magnesium (Mg), and calcium (Ca) during and after CABG between on-pump and off-pump procedure and the correlation between these trace elements and the development of postoperative AF.

Methods

Fifty-three CABG patients using on-pump or off-pump methods were enrolled. The blood sample was taken before skin incision (T1), 4 h after skin incision (T2), postoperative day1 (T3), and day3 (T4) respectively. Plasma concentrations of Mg, Ca, Fe, Zn, and Cu were determined.

Results

The plasma Mg concentration reached the highest level at T3 (0.94 ± 0.03 vs. 1.20 ± 0.03 mmol/L,P < 0.001) and completely recovered at T4 whereas Zn (11.28 ± 0.23 vs. 6.80 ± 0.20 mmol/L, P < 0.001) and Fe (10.97 ± 0.51 vs. 2.22 ± 0.1 μmol/L, P < 0.001) was lowest at T3 and partially recovered at T4. Cu was lowest at T2 (12.10 ± 0.33 vs. 9.62 ± 0.25 μmol/L, P < 0.001) then increased until T4. There were significant differences in Mg and Fe (P < 0.05), as well as Cu (P < 0.01) between on-pump and off-pump groups. No significant differences were detected between postoperative atrial fibrillation and sinus rhythm groups.

Conclusions

In CABG, Cu and Zn are significantly reduced and Cu is recovered at postoperative Day 1 but Zn takes longer to recover. Addition of Mg and Ca during CABG are sufficient to maintain the plasma concentration. However, supplementation of Cu and Zn during and after CABG may be necessary. Further, the correlation between these trace elements and postoperative AF is to be further determined.

中文翻译：

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冠状动脉旁路移植手术期间和之后血浆微量元素镁、铜、锌、铁和钙的变化。

背景

包括微量元素在内的饮食因素会导致包括冠状动脉疾病在内的疾病的发展。体外循环和非体外循环冠状动脉旁路移植术 (CABG) 之间是否存在微量元素浓度差异仍不清楚。本研究的目的是探讨体外循环和体外循环过程中 CABG 期间和之后四种微量元素 Cu、Fe、Zn、镁 (Mg) 和钙 (Ca) 的血浆水平差异及其相关性。这些微量元素与术后房颤的发展之间的关系。

方法

招募了 53 名使用体外循环或非体外循环方法的 CABG 患者。分别在切皮前（T1）、切皮后4小时（T2）、术后第1天（T3）和第3天（T4）采集血样。测定了 Mg、Ca、Fe、Zn 和 Cu 的血浆浓度。

结果

血浆 Mg 浓度在 T3 时达到最高水平（0.94 ± 0.03 对 1.20 ± 0.03 mmol/L，P < 0.001）并在 T4 时完全恢复，而 Zn（11.28 ± 0.23 对 6.80 ± 0.20 mmol/L，P < 0.001） ) 和 Fe (10.97 ± 0.51 vs. 2.22 ± 0.1 μmol/L, P < 0.001) 在 T3 时最低，在 T4 时部分恢复。Cu 在 T2 时最低（12.10 ± 0.33 vs. 9.62 ± 0.25 μmol/L，P < 0.001）然后增加到 T4。体外循环组和非体外循环组之间Mg 和 Fe ( P < 0.05) 以及 Cu ( P < 0.01) 存在显着差异。术后房颤组和窦性心律组之间没有检测到显着差异。

结论

在 CABG 中，Cu 和 Zn 显着减少，Cu 在术后第 1 天恢复，但 Zn 恢复需要更长的时间。在 CABG 期间添加 Mg 和 Ca 足以维持血浆浓度。然而，在 CABG 期间和之后可能需要补充 Cu 和 Zn。此外，这些微量元素与术后房颤的相关性有待进一步确定。