Kenan İLTÜMÜR, Aziz KARABULUT, NİZAMETTİN TOPRAK

Akut anteriyor miyokard infarktüsünde sol atriyal volüm değişiklikleri

Akut miyokard infarktüsü sonrası sol atriyal volümünün prognostik önemi bilinmektedir. Bu çalışma akut anteriyor miyokard infarktüsü (AMİ) geçirip sol ventrikül sistolik fonksiyonları kısmen korunmuş olan hastaların sol atriyal volüm değişiklikleri ve bu değişikliklerin diyastolik parametrelerle olan ilişkisini araştırmak amacıyla planlandı. Çalışmaya anteriyor AMİ'li 34 hasta ile aynı yaş ve cinsiyet ile uyumlu toplam 20 kontrol vakası alındı. Standart ekokardiyografik ölçümlere ek olarak atriyal volüm ölçümleri ve doku doppler analizi yapıldı. Kontrol grubu ile karşılaştırıldığında, sol atriyum maksimal volüm (43.6±8.8 ve 38.7±5.3 (p

Anahtar Kelimeler:

Miyokard enfarktüsü, Kalp kulakçığı, Ventriküler fonksiyon, sol, Ekokardiyografi

Atrial volume changes in anterior myocardial infarction

Prognostic value of left atrial volume after acute myocardial infarction (AMI)is well known. This study was planned to evaluate left atrial volume changes and the effect of these changes on diastolic parameters in patients with anterior myocardial infarction with preserved ejection fraction. Thirty-four consecutive patients with anterior AMI were enrolled in this study along with sex and age matched 20 normal controls. In addition, to the standard echocardiographic evaluation, left atrial (LA) volume measurements and tissue doppler analysis were done. Left atrial maximal volume (43.6±8.8 vs 38.7±5.3 ml; p<0.05) and volume p (32±7.6 and 24.1±4.9 ml; p<0.0001) were significantly higher in AMI group than normals. However, minimal volume (19.5±6.7 vs 16.8±5.6 ml; p>0.05) and total emptying volume (24.1±4.1 vs 22.1±2.9; p>0.05) were not significant between two groups. In AMI group, passive emptying volume and its fraction was lower, although active emptying volume and its fraction was higher than controls. At the same time pulmonary vein systolic and diastolic flows were lower in AMI group. There was a significant relationship between left ventricular diastolic parameters (mitral E/A and mitral tissue EVA') and LA active emptying volume in AMI group ( r= -0,35 and r=-0,36p<0,05, respectively). Our study suggested that left atrial volume changes are significant in the AMI. In addition, these changes are parallel to diastolic dysfunction. Left atrial volume changes may be used more confidently compared to mitral valve's diastolic parameters that are variable.

Keywords:

Myocardial Infarction, Heart Atria, Ventricular Function, Left, Echocardiography,

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