Mitral stenozda sol atrial volüm indexi ve Sağ ventrikül dilatasyonunun atrial fibrilasyon için prediktif değeri

Amaç: Mitral stenozda (MS) sol atrial volüm indeksi (LAVİ) ve sağ ventrikül dilatasyonunun atrial fibrilasyon (AF) için prediktif değerini inceleme ve cutoff değerini belirlemektir. Yöntemler: Mitral darlığı olan ve yaşları 23-86 arasında (Ortalama: 50,7±12,7) olan 14 erkek, 89 kadın, toplam 103 vaka çalışmaya alındı. Bütün ekokardiyografik değerlendirmeler Amerikan Ekokardiyografi Cemiyeti (ASE) kriterlerine göre yapıldı. Hastalar AF ve sinüs ritmi (NSR) olmak üzere iki gruba ayrıldı. AF olan 36 hasta AF Grubu ve Sinüs ritminde olan 67 hasta NSR Grubu olarak sınıflandırıldı. Bu iki grubun klinik, demografik, ekokardiyografik özellikleri karşılaştırıldı. İstatistiksel metod yazılacak Bulgular: Mitral kapak alanı azaldıkça sol atrial völüm indeksi ve sağ ventrikül diastolik çapı artmaktadır. Atrial fibrilasyon için LAVİ cut off değeri 40,74 ml/m2 olup sensitivitesi %80 ve spesifitesi %19.4 olarak bulundu. Atrial fibrilasyon sağ ventrikül diastolik çapı (RVDÇ) için cut off değeri 36,7 mm olup sensitivitesi %62,9 ve spesifitesi %40,3 olarak bulundu. Sonuç: Mitral stenozunda atrial fibrilasyon gelişimi için LAVİ ve RVDÇ cut off değerlerinin olduğu ve bu değerleri bilmenin tedavi stratejilerini belirlemede önemli olduğu kanaatine varıldı.

Anahtar Kelimeler:

Atrial fibrilasyon, Sol atrial volüm indeksi, Sağ ventrikül dilatasyonu, Mitral stenozu

Predictive Value Of Left Atrial Volume Index And Right Ventricular Dilatation In Mitral Stenosis For Atrial Fibrillation.

Purpose: To examine the predictive value of left atrial volume index (LAVI) and right ventricular dilatation in mitral stenosis (MS) for atrial fibrillation (AF) and to determine the cut-off value. Materials and Methods: 14 men, 92 women, a total of 106 cases between the ages of 23-86 (mean: 50.7 ± 12.7) with mitral stenosis were included in the study. All echocardiographic assessments were performed according to the criteria of American Society of Echocardiography (ASE). Patients were divided into two groups as AF and normal sinus rhythm (NSR). 39 patients with AF were classified as AF group and 67 patients with normal sinus rhythm were classified as NSR group. The demographic, clinical, echocardiographic characteristics of these two groups were compared. For the statistical analysis of datas, Kolmogorov-Smirnov, T-test, Mann-Whitney-U test and ROC analysis were used. Results: In mitral valve stenosis, left atrial volume index and right ventricular diastolic diameter increase. LAVI cut-off value for atrial fibrillation is 40,74 ml/m2, the sensitivity and specificity of it was found to be as 80% and 80.6%, respectively (PPV = 69.0%, NPV = 88.5%). Cut-off value of right ventricular diastolic diameter (RVDD) for atrial fibrillation is 36.7 mm, the sensitivity and specificity of it was found to be as 62.9% and 59.7%, respectively (PPV = 46.0%, NPV = 75.5%). Conclusion: It has been concluded that, there are cut-off values of LAVI and RVDD for the development of atrial fibrillation in mitral stenosis and to know those values that were important in determining treatment strategies.

Keywords:

Atrial fibrillation, Left atrial volume index, Right ventricular dilatation, Mitral stenosis,

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YazışmaAdresi / Address for Correspondence: Dr. AbdulmelikYıldız Seyit nizam mah.Balıklı çırpıcı sok. Kiptaş merkezevleri 2.Etap A 7 blok No:25 Zeytinburnu / İSTANBUL E-mail: drmelik@hotmail.com G eliştarihi/Received on : 21.04.2014

Kabul tarihi/Accepted on: 28.05.2014