Gamze AKKUŞ, Oğuz AKKUŞ, Kamil NAS, Esmeray ACARTÜRK, Emel GÜRKAN

Talasemi hastalarında demir yükü ile kardiyovasküler fonksiyonların ekokardiyografik indekslerle korelasyon çalışması

Amaç: Bu çalışmada talasemi majör ve intermedia hastalarında arteryel sertlik parametrelerinin ekokardiyografik ve osilometrik (arteriograf) yöntemlerle incelenmesi amaçlanmıştır.Gereç ve Yöntem: Çalışmaya her iki cinsiyetten 44 gönüllü katılımcı (24 talasemi hastası, 20 kontrol grubu) alındı. Hastaların hematolojik ve hemodinamik parametreleri kayıt edildi. Arteryel sertlik göstergesi olarak aortik arttırma göstergesi (aortic AG), nabız dalga hızı (NDH), aortic strain, distensibilite ve aortic sertlik indeksi bakıldı. Nabız dalga hızı ve aortic AG arteriyograf ile diğer parametreler ekokardiyografik olarak ölçüldü.Bulgular: Vasküler kompliyans belirleyicisi olarak bakılan parametrelerden aortik strain ve arteryel sertlik indeksi iki grup arasında anlamlı saptanmıştır. Aort nabız dalga hızı talasemi hasta grubunda sınırda anlamlı saptandı. Doku doppler ölçümlerinden erken (E‟) ve geç (A‟) mitral anüler diyastolik doluş hızları beta talasemi hastalarında kontrol grubuna göre anlamlı düşük saptandı.Sonuç: Ekokardiyografik doku doppler değerlendirmesi talasemi hastalarında diyastolik disfonksiyon gelişimini belirlemede yararlı bulunmuştur. Arteryel sertlik indeksleri, özellikle aortic strain, arteryel sertlik indeksi ve nabız dalga hızı, talasemi hastalarında demir birikimine bağlı vasküler yaşlanmayı belirlemede başvurulabilecek kolay ve güvenilir ölçümlerdir.

Anahtar Kelimeler:

talasemi, arteryel sertlik

The correlation study of cardiovascular functions and iron overload by echocardiographic indices in thalessemia patients

Purpose: The aim of this study was to evaluate arterial stiffness with echocardiographic and oscillometric (TensioMed arteriography) methods in thalassemia patients.Materials and Methods: We enrolled 44 participants from both gender (24 thalasemia patients, 20 control patients). Hematologic and hemodynamic parameters were recorded. Arterial stiffness was assessed non-invasively by measurement of pulse wave velocity, augmentation index, aortic strain, distensibility and arterial stiffness index by using TensioMed arteriography and echocardiography.Results: Aortic strain and arterial stiffness index were found to be significant between two groups. Pulse wave velocity had borderline significance between thalasemia and control patients. Tissue doppler early (E ') and late (A') mitral annular diastolic filling velocities in patients with beta thalassemia were significantly lower than the control group.Conclusion: Tissue doppler echocardiographic evaluation was useful in determining the development of diastolic dysfunction in patients with thalassemia. Arterial stiffness indices, especially aortic strain, arterial stiffness index and pulse wave velocity are a useful and easy methods to predict risk of vascular aging at thalassemia patients.

Keywords:

Thalassemia, iron overload,

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