Murat ZİYREK, Sinan ŞAHİN, A. İlker TEKKESİN, Murat ŞENER, Onur ŞEN

Transtorasik Ekokardiyografi de Nekrotik/ Fibrotik Miyokart İçermeyen Hastalarda Cerrahi Revaskülarizasyonun QT Dispersiyon Süresi Üzerine Etkisi

Giriş: QT dispersiyon süresindeki uzamanın kardiyak aritmiler ve ani kardiyak ölümle ilişkili olduğu bilinmektedir. Miyokardiyal iskemi, hipertrofi k kardiyomiyopati, elektrolit dengesizlikleri, kalp yetersizliği gibi durumların sebep olduğu elektriksel heterojenite QT dispersiyon süresini uzatır. Çalışmanın amacı, transtorasik ekokardiyografi de nekrotik doku içermeyen iskemik miyokardda cerrahi revaskülarizasyonun QT dispersiyon süresi üzerine etkisini incelemektir. Hastalar ve Yöntem: Koroner arter hastalığı nedeniyle cerrahi revaskülarizasyon yapılan hastalar retrospektif olarak tarandı. Dışlama kriterleri uygulandıktan sonra 247 hasta çalışmaya dahil edildi. Hastaların elektrokardiyografi leri incelendi. Preoperatif (QTcd0), postoperatif birinci (QTcd1), postoperatif üçüncü (QTcd3) ve postoperatif yedinci (QTcd7) gün düzeltilmiş QT dispersiyon süreleri hesaplandı ve birbirleriyle karşılaştırıldı. Bulgular: QTcd0 (83.6 ± 2.2) ile QTcd1 (55.3 ± 1.7), QTcd3 (50.4 ± 1.2) ve QTcd7 (45.3 ± 1.1) arasında istatistiksel olarak anlamlı fark vardı (sırasıyla p< 0.001, p< 0.001, p< 0.001). QTcd1 (55.3 ± 1.7) ile QTcd7 (45.3 ± 1.1), QTcd3 (50.4 ± 1.2) ile QTcd7 (45.3 ± 1.1) arasında da istatistiksel olarak anlamlı fark mevcuttu (p< 0.001). QTcd1 (55.3 ± 1.7) ile QTcd3 (50.4 ± 1.2) arasında ise istatistiksel olarak anlamlı fark yoktu (p= 0.078). Sonuç: Nekrotik/fi brotik doku içermeyen iskemik miyokardın cerrahi olarak revaskülarizasyonu postoperatif birinci günden itibaren QT dispersiyon süresinde anlamlı kısalmaya neden olmaktadır.

Anahtar Kelimeler:

Iskemi; miyokardiyal revaskülarizasyon; nekroz; kalp kası; ekokardiyografi

Effect of Surgical Revascularization on QT Dispersion Time in Patients Who Do Not Have Necrotic/Fibrotic Myocardium in Transthoracic Echocardiography

Introduction: Prolonged QT dispersion time is known to be associated with cardiac arrhythmias and sudden cardiac death. It was proved previously that electrical heterogenity caused by myocardial ischemia, hypertrophic cardiomyopathy, electrolyte imbalance, heart failure prolongs QT dispersion time. The aim of this study was to investigate the effect of surgical revascularization on QT dispersion time in ischemic patients not having necrotic/fi brotic segments in transthoracic echocardiography. Patients and Methods: Data of patients treated with surgical revascularization due to coronary artery disease are evaluated retrospectively. 247 patients were enrolled into the study after application of exclusion criteria. Patients' electrocardiographic records were evaluated and values of preoperative (QTcd0), postoperative fi rst (QTcd1), postoperative third (QTcd3) and postoperative seventh (QTcd7) day corrected QT dispersion time calculated and compared with each other. Results: There were statistically signifi cant differences between QTcd0 (83.6 ± 2.2) and QTcd1 (55.3 ± 1.7), QTcd3 (50.4 ± 1.2) and QTcd7 (45.3 ± 1.1) (p< 0.001, p< 0.001, p< 0.001 respectively). There was also statistically signifi cant difference between QTcd1 (55.3 ± 1.7) and QTcd7 (45.3 ± 1.1) (p< 0.001), and also between QTcd3 (50.4 ± 1.2) and QTcd7 (45.3 ± 1.1) (p< 0.001). There was no signifi cant difference between QTcd1 (55.3 ± 1.7) and QTcd3 (50.4 ± 1.2) (p= 0.078). Conclusion: Surgical revascularization of non-necrotic/non-fi brotic ischemic myocardium causes statistically signifi cant decrease in QT dispersion time from the postoperative fi rst day.

Keywords:

Ischemia myocardial revascularization; necrosis; myocardium; echocardiography,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi