Аңдатпа
Objective. Evaluation of the dynamics of epicardial fat thickness (EFT) in overweight patients after coronary artery bypass grafting in comparison with the dynamics of this indicator in individuals with normal body weight who underwent coronary artery bypass grafting. Materials and methods. The cohort study involved 91 patients. All patients were divided into 2 groups: group 1 – overweight patients after coronary artery bypass grafting (n=48) and group 2 – patients with normal body weight after coronary artery bypass grafting (n=43). The patients were examined on the first day after the blood flow was restored, then at the 1st, 2nd and 3rd stages of rehabilitation. A clinical examination, general examination with anthropometry, measurement of blood pressure and determination of body mass index were conducted. Among the instrumental research methods, transthoracic echocardiography was used. Statistical analysis of the data was carried out using the STATISTIC 12 software. Results and discussion. In group 1, at different stages of rehabilitation, it was revealed that the epicardial fat thickness index on the first day after coronary artery bypass grafting was 4.14±1.63, at the first stage of rehabilitation it decreased to 4.11 ±1.37, at the second stage it decreased to 3.69±0.66 and at the third stage of rehabilitation it increased to 4.54±1.28. Conclusions. In overweight patients who underwent coronary artery bypass grafting, in the postoperative period, the thickness of epicardial fat was 2 times higher than the thickness of epicardial fat in patients who also underwent coronary artery bypass grafting, but had a normal body weight. In overweight patients after coronary artery bypass grafting, the thickness of epicardial fat was statistically significantly higher by the 3rd stage of cardiorehabilitation compared to this indicator in them before the start of rehabilitation measures and significantly higher compared with the thickness of epicardial fat in patients with normal body weight who underwent coronary artery bypass grafting. An increase in epicardial fat thickness in combination with an increase in the left ventricular myocardial mass index can be considered as a predictor of insufficient effectiveness of cardiorehabilitation measures and destabilization of lipid metabolism in the epicardium of overweight patients who underwent coronary artery bypass grafting.