Akut dekompanse kalp yetersizliği hastalarında oksidatif stres indeksinin değerlendirilmesi

Amaç: Dekompanse kalp yetersizliği (KY), dokuların metabolik ihtiyacının karşılanamaması sonucunda çeşitli metabolik ve fizyolojik süreçlere yol açar. Bu süreçte üretilen reaktif oksijen türleri zararlı oksidatif reaksiyonlara yol açar. Bu çalışmamızda, akut dekompanse KY hastalarında uygulanan tedavinin oksidatif stres parametreleri ile ilişkisini ve bu parametrelerde düzelmeyi sağlayıp sağlamadığını araştırmayı amaçladık.Materyal ve Metot: Dekompanse KY nedeniyle yatan toplamda 40 hasta çalışmaya alındı. Hastaların yatışında tedavi öncesi ve taburculuk öncesinde tedavi sonrası antropometrik ölçümleri, ekokardiyografileri, rutin biyokimyasal parametreler yanında total antioksidan kapasite (TAK), total oksidatif seviye (TOS) ve bu ölçümlerin oranlarından elde edilen oksidatif stres indeksi (OSİ) hesaplandı.Bulgular: KY tedavisi sonrası nabız, sistolik kan basıncı ve diyastolik kan basıncında azalma, sol ventrikül ejeksiyon fraksiyonunda yükselme gözlendi (hepsi için p<0.05). Ek olarak KY tedavisi sonrası alınan TAK, TOS ve OSİ değerlerinin tedavi öncesi değerlere göre anlamlı olarak daha fazla olduğu izlendi (hepsi için p<0.05). Yapılan korelasyon analizinde TAK ile sistolik ve diyastolik kan basıncı arasında negatif bir ilişki olduğu (sırasıyla r: -0,307, p:0.014; r: -0,393, p:0.001), EF ile de TAK ve OSİ arasında negatif bir ilişki olduğu bulundu (sırasıyla r: -0,298, p:0.011; r:-0,326, p:0.005). Sonuç: Oksidatif stresin dekompanse KY hastalarında yüksek olduğu ve tedavi ile kompansasyon sonrasında da bu yüksek seviyelerinin devam ettiği görüldü. Literatürde akut dekompanse KY tedavisinin bu parametreleri ne düzeyde etkilediğini gösteren çalışmalar sınırlı ve sonuçları tartışmalı olduğundan, bu konu ile ilgili daha fazla çalışma yapılması gerekmektedir.

Anahtar Kelimeler:

total antioksidan kapasite, total oksidatif seviye, oksidatif stres indeksi, kalp yetersizliği

Evaluation of the oxidative stress index in patients with acute decompensate heart failure

Background: Decompansated heart failure (HF) causes various metabolic and physiological processes as a result of the failure to meet the metabolic needs of the tissues. Reactive oxygen species produced in this process cause harmful oxidative reactions. In this study, we aimed to investigate the relationship between the oxidative stres parameters and the treatment of acute decompensated patients with HF.Methods: A total of 40 patients with decompensated HF were included in the study. Anthropometric measurements, echocardiography, routine biochemical parameters, total antioxidant capacity (TAC), total oxidative level (TOL), and oxidative stres index (OSI) were obtained before admission and discharge.Results: Pulse rate, systolic blood pressure and diastolic blood pressure decreased and left ventricular ejection fraction was increased after standard HF treatment (p <0.05 for all ). Also post treatment TAC, TOL and OSI values were found to significantly higher than those pre-treatment values (p <0.05 for all). İn corelation analysis there was a negative correlation between TAK and systolic and diastolic blood pressure (r: -0,307, p: 0.014; r: -0,393, p: 0.001, respectively), and a negative correlation was found between EF and CT and OSI (r: - 0.298, p: 0.011; r: -0.332, p: 0.005, respectively). Conclusions: It was observed that oxidative stres was high in decompensated HF patients and these high levels were maintained in patients who were compensated after treatment. As there are limited studies on the effects of acute decompensated HF treatment on these parameters in the literature, further studies are needed on this subject, since the results are limited and the controversial.

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