Does Mild Renal Failure Affect Coronary Flow Reserve after Coronary Artery Bypass Graft Surgery?

Murat Günday, Özgür Çiftçi, Mustafa Çalışkan, Mehmet Özülkü, Hakan Bingöl, Kazım Körez, Sait Aşlamacı

Abstract

Introduction: There are only a limited number of studies on the link between mild renal failure and coronary artery disease. The purpose of this study is to investigate the effects of mild renal failure on the distal vascular bed by measuring the coronary flow reserve (CFR) in transthoracic echocar-diography after coronary artery bypass grafting (CABG)

Methods: The study included 52 consecutive patients (12 women and 40 men) who had undergone uncomplicated CABG. The patients were divided into 2 groups. Group 1 included patients with a preoperative glomerular filtra-tion rate (GFR) of 60-90 (mild renal failure), and group 2 included those with a GFR >90. The CFR measurements were carried out through a second harmonic transthoracic Doppler echocardiography.

Results: The mean age was 60.08 ± 1.56 years in group 1 and 60.33 ± 1.19 in group 2. The mean preoperative CFR was 1.79 ± 0.06 in group 1 and 2.05 ± 0.09 in group 2. The mean postoperative CFR was 2.09 ± 0.08 in group 1 and 2.37 ± 0.06 in group 2. There was a statistically significant difference between the 2 groups as to preoperative creatinine clearance, preopera-tive estimated GFR, postoperative day 7 creatinine clearance, postoperative month 6 creatinine clearance, postoperative day 7 estimated GFR, postoperative month 6 estimated GFR, pre-operative CFR, and postoperative CFR (P < .05). After bypass surgery, there was a significant increase in the mean postopera-tive CFR, when compared with the mean preoperative CFR (P = .001).

Conclusion: In our study, we detected a decrease in CFR in patients with mild renal failure. We believe that in patients undergoing CABG for coronary artery disease, mild renal failure can produce adverse effects due to deterioration of the microvascular bed.

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