Ayhan Usal, Mesut Demir, Ali Deniz, Mehmet Kanadaşı, Bülent Kaya, Çaglar Özmen, Rabia Eker Akıllı, Ömer Tepe

Hemodiyaliz hastalarında subklinik sol ventrikül diyastolik fonksiyon bozukluğu 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.

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

Purpose: In hemodialysis patients, detection of leftventricul diastolic dysfunction as early as possible iscritically important. The presystolic wave occurs in the leftventricul outflow tract and it’s associated with left ventriculstiffness and compliance. The aim of this study was toevaluate the clinical significance of presystolic wave in thedetection of diastolic dysfunction in hemodialysis patients.Materials and Methods: In this cross-sectional study,eighty hemodialysis patients and 88 healthy controls wereincluded in the study. The laboratory parameters weretested before the dialysis. The conventional B-mode,pulsed doppler parameters, doppler tissue-imaging, andpresystolic wave measurements were performed atechocardiography.Results: Presystolic wave was detected in 46.0% ofpatients and 18.1% of the control group. There was nostatistically significant difference between patients in termsof MPI, mitral E and A wave velocity, E/A and e’/a’ ratio,deceleration time, septal a’ and e’ wave velocity, and Sao ineither presence or absence of presystolic wave. In theunivariate model, higher Eao velocity and septal E/e’ ratio,and reduced duration of hemodialysis were determined asrisk factors for the presence of presystolic wave.Conclusion: The assessment of presystolic wave onechocardiography examination may provide importantinformation about the left ventricul diastolic function. Butwe have demonstrated in this study that presystolic waveis not entirely associated with left ventricul diastolicdysfunction in hemodialysis patients.

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