Journal of Cardiac Surgery | 2021
Patients after coronary artery bypass grafting with special reference to cardiometabolic syndrome, exercise and sleep
Abstract
I have read with great interest by Zapata et al., in which the authors evaluated the effects and outcomes of coronary artery bypass graft (CABG) in patients with cardiometabolic syndrome (CMS). The risk of CMS for long‐term survival significantly increased, which might be related to comorbidities by CMS. There is a need for risk reduction by controlling CMS and I want to present information on exercise and sleep in patients after CABG. First, Muthukrishnan et al. conducted a prospective study to determine the predictors of poor sleep quality among patients 3 months after CABG. The odds ratio of diabetes, body mass index > 30 kg/m, sedentary lifestyle and preoperative state anxiety for poor sleep quality significantly increased, and a state of anxiety was the most significant contributor to poor sleep. This means that anxiety status and CMS might affect subsequent poor sleep quality in patients with CABG. As some components of CMD are closely related to subsequent sleep status, risk assessment of prognosis should be conducted comprehensively. Second, Atef et al. evaluated the effect of different exercise types on sleep quality and functional capacity after CABG. The 6‐min walk test was used to assess functional capacity, and the patients were reviewed 6–8 weeks after surgery by allocating to either the aerobic group (AG) or aerobic and resistance group (ARG). There were significant decreases in the mean value of sleep latency, the fragmentation index, light sleep duration, and sleep quality scores, and significant increases in the total sleep duration, deep sleep duration, sleep efficiency, and functional capacity in both the AG and ARG after the interventions. As the difference was predominant in the AG, and type of exercise should be considered for keeping good sleep quality. Third, Nerbass et al. evaluated the effect of massage therapy on sleep quality in patients after cardiopulmonary artery bypass graft surgery. The patients were evaluated using a visual analog scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. The participants in the massage therapy group had fewer complaints of fatigue and reported better sleep quality than the control group, and exercise in combination with other physical interventions should be conducted for improving sleep quality. Anyway, exercise improved sleep quality and functional capacity, and the long‐term prognosis in patients after CABG should be conducted by including lifestyle factors, which would contribute to the change of CMS.