Çağlar ÖZMEN, Bülent KAYA, Rabia EKER AKILLI, Ömer TEPE, Ali DENİZ, Mehmet KANADAŞI, Mesut DEMİR, Ayhan USAL

Hemodiyaliz hastalarında subklinik sol ventrikül diyastolik disfonksiyonu tanısında prestostolik dalga yetersiz kalmıştır

Amaç: Hemodiyaliz hastalarında, sol ventrikül diyastolik fonksiyon bozukluğunun mümkün olduğu kadar erken saptanması kritik öneme sahiptir. Presistolik dalga sol ventrikül çıkış yolunda saptanmaktadır ve sol ventrikül sertliği ve uyumu ile ilişkilidir. Bu çalışmanın amacı, hemodiyaliz hastalarında presistolik dalganın diyastolik fonksiyon bozukluğunun saptanmasında yardımcı olup olamayacağını değerlendirmektir.Gereç ve Yöntem: Bu kesitsel çalışmada, 80 hemodiyaliz hastası ve 88 sağlıklı kontrol çalışmaya dahil edildi. Laboratuvar parametreleri diyalizden önce test edildi. Ekokardiyografide konvansiyonel B mod, darbeli doppler parametreleri, doppler doku görüntüleme ve presistolik dalga ölçümleri yapıldı.Bulgular: Presistolik dalga hastaların % 46.0'sında ve kontrol grubunun % 18.1'inde tespit edildi. Hastalarda miyokard performans indeksi, mitral E ve A dalga hızı, E / A ve e '/ a' oranı, deselerasyon zamanı, septal a' ve e' dalga hızı ve Sao açısından presistolik dalga olan ve olmayan arasında istatistiksel olarak anlamlı fark yoktu. Univariate analiz sonucunda, yüksek Eao hızı ve septal E / e ’oranı ve kısa hemodiyaliz süresi presistolik dalga varlığı için risk faktörü olarak belirlendi.Sonuç: Ekokardiyografik olarak presistolik dalganın değerlendirilmesi sol ventrikül diyastolik fonksiyonu hakkında önemli bilgiler sağlayabilir. Ancak çalışmamızda presistolik dalganın hemodiyaliz hastalarında sol ventrikül diyastolik fonksiyon bozukluğu ile ilişkili olmadığını gösterdik.

Anahtar Kelimeler:

Diyastolik disfonksiyon, hemodiyaliz, kalp yetersizliği

The presystolic wave was not sufficient for diagnosing subclinical left ventricular diastolic dysfunction in hemodialysis patients

Purpose: In hemodialysis patients, detection of left ventricul diastolic dysfunction as early as possible is critically important. The presystolic wave occurs in the left ventricul outflow tract and it’s associated with left ventricul stiffness and compliance. The aim of this study was to evaluate the clinical significance of presystolic wave in the detection of diastolic dysfunction in hemodialysis patients. Materials and Methods: In this cross-sectional study, eighty hemodialysis patients and 88 healthy controls were included in the study. The laboratory parameters were tested before the dialysis. The conventional B-mode, pulsed doppler parameters, doppler tissue-imaging, and presystolic wave measurements were performed at echocardiography. Results: Presystolic wave was detected in 46.0% of patients and 18.1% of the control group. There was no statistically significant difference between patients in terms of MPI, mitral E and A wave velocity, E/A and e’/a’ ratio, deceleration time, septal a’ and e’ wave velocity, and Sao in either presence or absence of presystolic wave. In the univariate model, higher Eao velocity and septal E/e’ ratio, and reduced duration of hemodialysis were determined as risk factors for the presence of presystolic wave.Conclusion: The assessment of presystolic wave on echocardiography examination may provide important information about the left ventricul diastolic function. But we have demonstrated in this study that presystolic wave is not entirely associated with left ventricul diastolic dysfunction in hemodialysis patients.

Keywords:

diastolic dysfunction, hemodialysis, heart failure,

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