Aşil tendonu gerinim oranı ile mitral anulus kalsifikasyonu varlığı arasındaki ilişki

Amaç: Aşil tendonu (AT)- ultrasonografisi (US) ve gerinim elastografisi (SE) ile elde edilen AT- kalınlığı (T) ve AT- gerinim oranının (SR) mitral kapak kalsifikasyonlu (MAC) hastaları belirlemedeki önemini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya ekokardiyografi sonrası MAC tanısı alan 100 hasta (65 kadın, 35 erkek ve ortalama yaş 64.7 ± 12.1) ve kardiyovasküler risk faktörü benzer olan 50 kontrol (32 kadın, 18 erkek ve ortalama yaş 63.2 ± 12.8) alındı. Laboratuvar incelemeler ve AT US yapıldı. AT-T ve AT-SR hesaplandı. Bulgular: MAC olan hastalarda AT-T ve AT-SR belirgin olarak yüksek olduğu bulundu. Logistic regresyon analizinde, AT-T ve AT-SR değerlerinin MAC olma riskini bağımsız olarak belirlediği bulundu. Bu analize göre AT-T (her 1 mm) ve AT-SR (her 0.1)’nin MAC olma riskini sırası ile %69.9 ve %12.7 oranlarında artırdığı saptandı. AT-T ve AT-SR değerlerinin MAC olan hastaları belirlemesi açısından ROC analizi yapıldığında, ROC eğri altında kalan alanın sırası ile 0.684 ve 0.819 belirlendi. Aynı analizde, AT-SR için sınır değer 1.25 olarak alındığında %94.1 sensitivite ve %76.2 spesivite ile MAC varlığını belirlediği tespit edildi. Sonuç: AT SE incelemesinde saptanan AT-SR, MAC olan hastaları önceden belirlemede kullanılabilecek basit, ucuz, tekrarlanabilir ve non-invaziv bir parametredir. Bu durum MAC ve AT-SR artışının benzer fizyopatolojik mekanizma ile meydana gelebilmesinin bir sonucu olabilir.

Relationship between the Achilles tendon strain ratio and the presence of mitral annulus calcification

Purpose: We aimed to investigate the significance of Achilles tendon (AT) thickness (T) and AT strain ratio (SR), determined by AT ultrasonography (US) and strain elastography (SE), in determining patients with mitral annulus calcification (MAC). Materials and Methods: 100 patients (65 females, 35 males, mean age 64.7 ± 12.1 years) diagnosed with MAC after echocardiography and 50 control subjects (32 females, 18 males, mean age 63.2 ± 12.8 years) with similar cardiovascular risk factors were included. Laboratory tests and AT US were performed. AT T and AT-SR were calculated. Results: AT -T and AT-SR were found to be significantly higher in patients with MAC. In multivariate logistic regression analysis, AT -T and AT-SR independently determined the risk for MAC. According to this analysis, AT -T (1 mm each) and AT-SR (0.1 each) increased the risk for MAC by 69.9% and 12.7%, respectively. When ROC was analyzed using AT -T and AT-SR to predict patients with MAC, the areas under the curve (AUC) of ROC were 0.684 and 0.819, respectively. In the same analysis accepting the cut-off value of 1.25 for AT-SR, the presence of MAC was detected with a sensitivity of 94.1% and a specificity of 76.2%. Conclusion: AT-SR detected in AT SE examination is a simple, reproducible, inexpensive, and noninvasive parameter that can be used to predict patients with MAC. This may be due to the fact that the increase in MAC and AT-SR may be associated with similar physiopathological mechanisms.

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