A Preliminary Study On The Relationship Between Myocardial Insulin Sensitivity And Cardiac Function After Open Heart Surgery In Infants With Congenital Heart Disease

Objective: To investigate the relationship between myocardial insulin sensitivity and cardiac function before and after open heart surgery in infants with congenital heart disease.Methods:(1)case selection: from December 2018 to April 2020,17 children with congenital heart disease,17 children with congenital heart disease,9 men and 8 women,with an age of 32~660 days,with an average age of(241.82±174.53)days,underwent surgery for direct heart surgery in our hospital.Weight 2.8~11.0 kg,average weight(6.57±2.31)(2)Insulin sensitivity assessment: the glucose concentration and insulin concentration of blood samples were measured in peripheral arterial blood and coronary vein blood three ml,before aortic occlusion and three min after cardiac repulse.(3)Heart function assessment: respectively noninvasive cardiac detection before the operation,6 hours after the operation,24 hours after the operation,48 hours after the operation,detection indexes includingcardiac output(CO),stroke volume index(SI),cardiac index(CI),index of contractility(ICON),pre-ejection period(PEP),LV ejection time(LVET),systolic time ratio(STR),postoperative cardiovascular active pharmaceutical dosage and rate.Results:(1)The concentration of insulin after aortic opening in children was significantly higher than that before aortic blockade,P<0.05,the difference was statistically significant.after aortic opening,the insulin sensitivity index of children was significantly lower than that of pre-aortic blockade,P<0.05,the difference was statistically significant.(2)The index of contractility(ICON)and LV ejection time(LVET)were reduced and the maximum VIX(24max)of the Vasoactive-inotropic score was greater at24 h than at 24-48 h.(3)Spearman correlation analysis showed no significant correlation between insulin sensitivity index and aortic occlusion time,postoperative vasoactive-inotropic score and postoperative cardiac function.Conclusion:The clinical study of the small samples showed that there was obvious myocardial insulin resistance after open heart operation in infants with congenital heart disease,and there was a decrease in left ventricular systolic function after surgery,but there was no significant correlation between myocardial insulin resistance and postoperative cardiac function.